Tuberous Breast Surgery

Breast Reconstruction Techniques for Tuberous Breast Correction

Surgery to correct tuberous breasts is a customized procedure that may involve several different cosmetic and reconstructive surgery techniques. Dr. Cassileth will create your surgical plan to meet your unique needs and goals.

Fat Grafting

Your own natural fat is placed in areas where the breast never developed, rounding and filling out the breast shape. Fat is usually grafted as a "doughnut", supplementing the normal tissue. The fat is harvested from another area of the body using liposuction and then transferred through the breast's thinner tissue to improve contour.

Breast Augmentation

Breast implants may be used, often in the subfascial position, to ensure they stay at the new inframammary crease position. With breast asymmetry, Dr. Cassileth usually performs a breast reduction (mastopexy) on the larger breast and then uses the same implant size for better long-term symmetry. This technique can also minimize the chance of recurring asymmetry with breast aging and/or weight change.

Breast Unrolling

Many tuberous breasts have too short a distance between the nipple and the inframammary fold, which is the crease under the breast. There may be too much tissue directly behind the nipple, but not enough at the bottom where the breast should be. The breast tissue can be "unrolled" for these patients, enabling the breast behind the nipple to unroll into a lower position— similar to unrolling a window shade. This can be done through an incision either at the nipple or at the new crease location, making the nipple less prominent and lowering the breast.

Breast Reduction

Often, the larger breast, or both breasts, are reduced in size, and a breast lift can be performed at the same time if necessary. The reduction is not performed in a typical manner but instead focuses on removing extra tissue contributing to the tuberous shape.

Crease Release

During traditional repair of tuberous breasts, silicone or saline breast implants are placed and the existing inframammary crease is "scored" or "released" to get rid of the dent where the old crease used to be. Dr. Cassileth finds that this is often not enough, as there is thicker tissue above the old crease and thinner tissue below, and the dent is still evident, even after surgery. Unrolling or fat grafting helps to even out the tissue more than scoring.

Tissue Expansion

In rare cases, tissue expansion may be used for correction of tubular breasts. This is typically recommended for patients who desire large breasts but have severe tubular breast deformity with very tight skin. In these cases, a tissue expander may be used to expand the breast tissue with an eventual swap for an implant a few months after.