The tuberous breast, in many cases the patient is unaware of their diagnosis, it affects one or both breasts causing many major psychological disorders to the women carrying this malformation. It is characterized by a lack of growth of the breast on its base or contour, adopting in some cases the shape or a tubercle of roots.
It is characterized by a lack of growth of the breast on its base or contour, adopting in some cases the shape or a tubercle of roots. This anomaly is also known as tubular breasts, constricted breast or “Snoopy” deformity, and their appearance incidence is 30-40% of the patients that come to our consult for mammoplasties.
Even though the cause of this deformity is still unknown, the constrictive band or ring at the base of the breast prevents its development at the base causing the gland to herniate or protrude outside, generating a tubular shape, pushing the areola to the exterior.
There are many surgical maneuvers that can be preformed to achieve a good result, and an inadequate valuation of the following can take us to an unsatisfactory result.First we should reduced the areolar diameter avoiding a postop dilatation, for it a non absorbable suture should be performed. Because of this the approach should be periareolar, then we do a glandular flap to fill the inferior pole. This is the most complicated and high-risk part of the surgery, because of mistreat, bad management of the tissue, inferior pole necrosis or flap necrosis. Finally we include a mammary implant of cohesive gel appropriate to each case to favor the expansion of the inferior poles.
Since the implant must be placed beneath the Pectoralis Major muscle, we should use a special brassiere for this case for a minimum of a month, with a stabilizing Velcro band, to block the pocket behind the muscle, avoiding the implant to move or be expelled by the contraction of the muscle. The patient can’t raise her arms or move her elbows away from the thorax for a period of around a month, neither drive or perform any activities of great exertion. Should also sleep facing up and will also need help to bathe and feed for at least two weeks following the procedure.
The surgical treatment of the tuberous breast demands a very thorough knowledge of the deformity and published techniques.
The simple placement of an implant or prosthesis would cloud the result since the constriction ring at the base of the breast would generate a “ double bubble or double furrow”, which we usually see on patients that have gone througha simple breast augmentation surgery caused by the surgeon not being able to diagnose the deformity.