Breast asymmetry is a common concern among women, and one specific condition that contributes to this is tuberous breasts. While the exact prevalence of tuberous breast deformity is not well documented, it is considered a relatively congenital condition. Some studies suggest that it may impact up to 5% of the female population, but due to variations in severity, many cases go undiagnosed.
In this article, Dr Turner, a Specialist Plastic Surgeon in Sydney, aims to shed light on what tuberous breasts are, how they are classified, the surgical options available for correction, and whether Medicare will cover these procedures.
What Are Tuberous Breasts?
Tuberous breasts, also known as tubular or constricted breasts, are a developmental deformity that becomes apparent during puberty. This condition results in breasts that are unusually shaped due to constricted tissue at the base, causing them to appear elongated or tube-like. Characteristics of tuberous breast deformity may include:
- High breast folds
- Enlarged, puffy areolas
- Wide spacing between the breasts
- Minimal breast tissue, especially in the lower quadrants
This condition can affect one or both breasts, leading to noticeable asymmetry.
Tuberous Breast Classification
Understanding the severity of tubular breasts is essential for determining the appropriate corrective measures. The condition is typically classified into three grades:
Grade I
Grade I tuberous breasts involve minor constriction of the lower medial (inner) quadrant. The breasts appear mostly normal, with only slight underdevelopment in the affected area. Mild asymmetry may be present, but it often goes unnoticed under clothing and may not cause significant concern for the individual.
Grade II
In Grade II, there is constriction of both lower quadrants of the breast. This results in breasts that appear elongated, with underdeveloped lower portions and enlarged areolas. The asymmetry is more pronounced at this stage, leading to potential self-consciousness and a greater likelihood of individuals seeking corrective measures to improve their breast appearance.
Grade III
Grade III represents the most severe form of tuberous breast deformity, characterized by severe constriction of all quadrants with a minimal breast base. The breasts have a significant tubular shape, minimal breast tissue, and highly pronounced areolas. This marked asymmetry often has a profound psychological impact, prompting individuals to seek corrective surgery to enhance both their physical appearance and self-esteem.
What Plastic Surgery Procedures Are Available for Tuberous Breasts?
Tuberous breast deformity can be effectively corrected through various surgical procedures, each tailored to the individual’s specific needs and the severity of the condition. The primary goal of these surgeries is to reshape the breasts to achieve a more natural and symmetrical appearance. Below are some of the most common surgical options available:
Breast Augmentation
Breast augmentation involves the insertion of silicone breast implants to increase the size and shape of the breasts. In the case of tuberous breasts, the surgeon may need to release the constricted lower pole tissue (glandular modification) to allow the implant to expand the breast more evenly. This expansion helps in reshaping the breast to a more rounded form. The implants are typically placed beneath in a subfascial or dual plane placement, depending on the individual’s anatomy and desired outcome. Correction of volume asymmetry and tubular shape can be partially corrected by using different size breast implants.
Tissue Expansion
In younger patients, with tight skin and constricted breast tissue Dr Turner will often use a tissue expansion as part of a two-step process. First, a tissue expander—a balloon-like device—is temporarily inserted under the breast tissue during the first procedure, frequently in combination with fat grafting to correct the lower breast pole deficiency and tubular shape. Over several months, the expander is gradually filled with saline solution during visits to Dr Turner’s Manly clinic, slowly stretching the skin and underlying tissue. Once the tissue has expanded sufficiently, the second stage surgery is performed to replace the tissue expander with a silicone breast implant. During this second stage, Dr Turner will frequently perform further fat grafting and correct the areolar herniation.
Areola Reduction
Areola correction or areola reduction surgery involves removing a concentric area of excess areolar tissue around the perimeter of the areola to reduce the size of enlarged or puffy areolas. The incision is typically made along the border of the areola to minimize visible scarring. After the excess tissue is removed, the surrounding skin is sutured to the remaining areola, resulting in a smaller, more proportionate size and reduced areolar herniation.
Mastopexy (Breast Lift)
A mastopexy involves removing excess skin and tightening the surrounding breast glandular tissue to elevate the breasts. The procedure may also include repositioning the nipple and areola to a higher, position on the breast mound. In some cases, the surgery can be combined with breast augmentation or fat grafting if additional volume is desired.
Fat Grafting
Fat grafting, also known as lipofilling, involves harvesting fat from another area of the body—such as the abdomen, thighs, or hips—using liposuction techniques. The harvested fat is then purified and carefully injected into the breasts to improve the tubular breast shape and contours. While this method can be used alone, it is frequently combined with other procedures, like breast augmentation to refine the breast shape.
Dr Turner routinely uses a combination of these procedures, often as a staged approach in tuberous breasts, to achieve optimal results. The choice of procedure(s) depends on various factors, including the degree of tissue constriction, skin elasticity, breast size, and personal aesthetic goals.
Learn more about tuberous breast surgery
Does Medicare Cover Tuberous Breast Correction?
In Australia, Medicare may offer rebates for surgical procedures considered medically necessary, and tuberous breast correction can fall under this category under specific conditions. The deformity must be significant enough to significantly affect normal function or cause psychological distress. A thorough medical assessment and proper documentation by Dr Turner is required to establish where you will be eligible for Medicare coverage.
It’s important to understand that Medicare may not include all associated costs, such as hospital fees, anaesthesia and breast implant. Patients are encouraged to check with Medicare and their private health insurance providers to fully understand the extent of the coverage and any out-of-pocket expenses they may incur.
Next Steps
If you suspect you have tuberous breasts and are considering corrective surgery, here are your next steps:
- Schedule a Consultation: Contact us at 1300 437758 or visit drturner.com.au to book your appointment.
- Prepare for Surgery: Follow any preoperative guidelines provided, such as avoiding certain medications and arranging for post-surgery care.
- Plan for Recovery: Set aside time for rest and healing and arrange for assistance during your initial recovery phase if needed.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional to determine the best treatment options for your individual needs.
