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Tuberous Breasts Surgery

Tuberous Breast Surgery in Sydney and Newcastle by Dr Scott Turner Plastic Surgeon

  • Do you have Puffy nipples?
  • Conical or Pointy Shaped Breasts?
  • Unusual-looking Breasts that are Under-Developed?

You might have a condition called tuberous breasts or tubular breasts.  Tuberous breast deformity is a condition that affects many girls during puberty as breasts develop. It can be described as having small conical breasts with pointy or puffy nipples that are set too wide apart. Although tubular breasts do not impose any medical or health concerns, they can be a great source of anxiety and social distress. Many young girls avoid wearing revealing clothes and intimate situations out of embarrassment.  Fortunately, it’s not something that you have to just live with for the rest of your life. From breast augmentation to areolar correction to fat grafting procedures, there are several options for correcting tuberous breasts.

What Are Tuberous Breasts?

A lot of women have a condition called tuberous or tubular breasts. While every woman has slightly mismatched breasts, women with tuberous breasts are dealing with a very obvious difference in the appearance of their breasts. Tuberous breast syndrome is a term that we used to describe several different issues. Droopy breasts, enlarged areolas, herniation of breast tissue through the nipple, malformation of the breast base and other problems are all part of what it means to have tuberous breasts.

Women with tuberous breasts typically notice the issue during puberty. As their breasts develop, the difference between their breasts’ size and shape becomes clearer. Not all breasts are born equal. Every woman has a certain level of uniqueness in her breasts’ shape and size.

However, if your breasts are remarkably small, narrow, cone-shaped, widely spaced, and asymmetric, they may be tuberous. Tuberous breasts are also often accompanied by large areolas (pigmented skin around the nipple) and puffy nipples that point downward or “droop”. The condition is more common than you might expect. One study showed that around 90% of reported breast asymmetry cases were also tuberous breasts.

Do You Have Tuberous Breasts?

Dr. Turner will be able to tell if you have tubular breasts based on the following:

  • If your breasts are remarkably smaller than average
  • If your breasts look narrow and/or conical when viewed from the side
  • If there is a constriction around your nipple
  • If there is a gap of 1.5 inches or more between your breasts
  • If you have noticeably asymmetric breasts (one is obviously larger than the other)
  • If your breasts appear droopy, oval, pointy, conical, or square-shaped
  • If your areolas are larger than normal

If you’re unsatisfied with how your breasts look, and you suspect that they might be tuberous, you can have them properly assessed by a qualified plastic surgeon. You should choose a certified plastic surgeon who is familiar with diagnosing and treating tubular breasts and not just any surgeon.

What causes tubular breasts?

Tuberous breast deformity happens when your breasts fail to properly develop during puberty. It can affect one or both breasts. It’s still not very clear what causes tuberous breasts. Some doctors believe that it’s congenital; the result of an unknown event that occurs during fetal development. The result of this event, however, will only become evident during puberty as the breasts develop.

Regardless of the initiating factor, tuberous breasts fail to develop enough tissue to become round, large, and perky. Instead, women with tuberous breasts end up with narrow, tube-shaped, and small breasts. In many cases, the tissue ring that surrounds the nipple also fails to properly develop, leading to puffy droopy nipples. 

Types of Tuberous Breasts – Three Grades – What are the different degrees of tubular breasts?

Dr. Turner first assesses the type or grade of your tuberous breasts before giving you any treatment options.

Tubular breasts are classified into three types based on their severity:

  • Grade I: This is the least severe type. If your breasts lack tissue in the lower and middle regions, then you may have type I tuberous breasts. This is the most common type. It gives your breasts a “smaller than average” appearance.
  • Grade II: There is more tissue deficiency in this type than in type I. The entire lower half of the breast is affected. The areola in type II tuberous breasts is usually enlarged, stretched, and points downwards.
  • Grade III: This is the most severe type. In this case, the breast growth is constricted in all four quadrants of the breast; the entire breast is severely affected. The areolar tissue is stretched thin and weakened. Unlike women with small breasts, women with this type of tuberous breasts may struggle with breastfeeding.

Like most medical issues, self-diagnosis isn’t the best solution. The only way to know your exact grade is to talk to a professional. When to you come to our Sydney or Newcastle clinic, Dr Turner will examine your breast and tell you what your grade level is.

Traditional Techniques to Treat Tuberous Breasts

Tuberous breast asymmetry has traditionally been treated by the combination of a breast lift procedure to reshape the breast and breast augmentation surgery to increase breast volume.

The most common breast lift procedure used is a periareolar (Benelli) breast lift technique. In this procedure, there is an incision around the areolar and is an excellent technique to lift and reduce the size of the areolar so that it’s centered over the breast mound. This also reduces herniate breast tissue and decreases the puffiness of the nipple.

In the majority of women undergoing tuberous breast asymmetry correction, a breast augmentation is performed. Not only does the breast implant increase the overall breast volume, but it widens a constricted breast and add volume to the lower pole of the breast which is invariably deficient. To allow the breast implant to expand, a plastic surgeon will often perform glandular scoring cutting to release the internal contractures to allow the breast implant to expand the breast shape.

Tuberous Breasts Correction Surgery

Tuberous breasts correction can help give you the round and perky breasts you’ve always wanted. Dr. Scott Turner is a specialist plastic surgeon and top tuberous breast expert and offers several techniques to correct the condition. Depending on your unique anatomy and desires, Dr. Turner will help you choose the best solution for you. 

What are the Benefits of tubular breast correction surgery?

Having tuberous breasts can weigh heavily on your psyche. Many women struggle before being able to seek correction due to feelings of insecurity or embarrassment.

Tubular breast correction surgeries offer significant benefits not only physically but also psychologically and emotionally. They include:

  • Getting larger and more natural-looking breasts
  • Getting a well-contoured cleavage
  • Wearing bikini tops confidently
  • Easily finding bras that fit well
  • Feeling confident topless
  • Restoring your self-esteem and removing feelings of insecurity
  • Maintaining healthier romantic relationships and an improved sex drive
  • Getting an increased sense of worthiness and positive body image

Fat Grafting for Tuberous Breasts by Dr Scott Turner

Three Different Surgery options for Tubular Breasts

Tubular breasts can only be treated with corrective surgery. This can be achieved either by traditional surgical reconstruction (with or without implants) or by fat grafting.

Regular cosmetic surgery would not be enough to fully correct tubular breasts. So, it’s important to choose a surgeon who has experience specifically treating tubular breasts.

1. Traditional Surgical Correction for Tuberous Breasts

Traditional correction of tuberous breasts usually involves surgical tissue remodeling (similar to a breast lift) with or without breast implants. It is usually done using a periareolar (around the nipple) incision.

Tuberous breasts reconstruction usually involves:

  • The release of the constricted tissue around the base of the breast to round it out (a process known as glandular scoring)
  • Spreading out some of the breast’s tissue into the lower part where it’s lacking
  • Reshaping of the inframammary fold to create a clear lower breast slope
  • A breast lift to reposition the nipple at a more proportional level
  • A reduction in the size of the areolas in case they are enlarged
  • Decreasing the gap between your breasts

If your native breast tissue is not enough to produce satisfactory results, you may also need breast implants. This may require two separate surgeries in some cases.  (This can be combined as one procedure in the grade I type tuberous breast – but those with grade II and III often require a staged procedure over 9-12mths)

Use of an expander is only for severe grade III tuberosity – most cases is direct to implant for grade I. and II.

  • During the first surgery, Dr. Turner implants tissue expanders (temporary inflatable implants)
  • The expanders stretch out your chest muscles and skin making room for the future implants.
  • They will be kept in place for several weeks or months and will be regularly inflated by Dr. Turner.
  • Once your breasts are large enough, you will receive a final corrective surgery, and the expanders will be replaced by definite implants.

In most cases, breast implants alone are not enough, and surgical remodeling (lifting) is done to achieve satisfactory results. In such cases, the lift would take care of the sagging and give the breasts a perkier and younger look.

What are the advantages of traditional correction?

  • Round breast base that will remove the tubular appearance
  • Increased breast symmetry
  • Bigger and fuller breasts that are more aesthetically pleasing
  • Enhanced breast contour and a more prominent cleavage
  • Long-lasting results
  • Less breast gap

What are the disadvantages of traditional correction?

Since there are different degrees and types of tuberous breasts, traditional tuberous breast correction could have some limitations:

  • Visible implant edges if there’s too little tissue in the lower portion of the breast (creates an unnatural look)
  • The positioning of the implant can result in a wide cleavage
  • Double bubble effect if the implant sinks below the lower portion of the breast due to lack of lower breast support
  • More recovery time would be needed after the implants are inserted
  • Possible loss of sensation in the nipples
  • Risk of hematoma, seroma, or post-surgery infections
  • Breast scars (although, they can be well hidden)

2. Fat grafting for Tuberous Breasts

Fat grafting has become a very popular solution for women who want to fix their tuberous breasts without implants. It offers a more natural treatment for tuberous breasts, with no prosthesis involved.

Fat grafting is a less invasive operation compared to traditional remodeling and implants. During this procedure, Dr. Turner removes excess fat from one region of your body (e.g. hips, belly, thighs, etc.) by liposuction and injects it into your breasts. This allows him to strategically inflate your breasts and remodel them, fixing their tuberous appearance and pumping up their volume.

Moreover, the injection of the fat beneath the skin loosens up the constricted tissue. This further helps fix the pointy appearance of the nipples.

What are the advantages of fat grafting?

For women with less severe types of tubular breasts, fat grafting can be a simple way to correct the deformity, and it has the following advantages:

  • Strategic targeting of specific areas of the breast
  • Enlargement and enhancement of any breast region as needed
  • Less recovery time
  • Natural breast mound appearance
  • No glandular scoring (less breast tissue damage)
  • Less surgical complications such as hematoma, seroma, and infection
  • No risk of double bubble deformity
  • Softening of the breast
  • No scarring
  • Simultaneous contouring of other body parts (donor sites)

What are the disadvantages of fat grafting?

Fat grafting might have some cons as well:

  • You might not be able to significantly increase your breast size
  • You may need several sessions to achieve long-lasting effects
  • Pre-expansion techniques might be needed to give you long term outcomes
  • If too much fat is injected at once, fat necrosis (cell death) can occur resulting in hard lumps

Can Fat Grafting help Tuberous Breasts?

Fat grafting or Fat Transfer is the process of taking fat from another part of the body and moving it to another area. This fat transfer increases breast volume and creates a natural look. Fat grafting lets you gain one cup size without a breast implant. A fat transferring procedure can be done in conjunction with breast implants as well. The process of doing fat grafting with breast implants is called composite breast augmentation or lipoimplant.

One incredible benefit of doing a fat transfer is that areas of your breast can be selectively thickened. Once the soft tissue is thickened, an implant can be placed above the muscle to create a natural look with enhanced cleavage. Composite breast augmentation eliminates the need to rely on glandular scoring, which is another major benefit.

In the past, fat grafting was done with the same old style technique and equipment used for liposuction. This procedure wasn’t ideal and has since been transformed. These day, fat grafting is less invasive than other options for breast asymmetry. At our Sydney NSW clinic, we utilise the latest fat grafting techniques with the BodyJet Evo for a safe and simple solution.

When you have a fat transferring procedure done, fat is transferred to underneath your skin. The tight skin of tuberous breasts is spread out to create a natural looking curve. To get an in-depth view on breast asymmetry and fat grafting, check out our page on tuberous breast asymmetry. 

3. Hybrid Breast Augmentation – Implant and Fat Grafting

Fat grafting does not necessarily have to be done alone. It can be combined with breast implants to achieve the best results possible. This is called a hybrid augmentation or composite breast augmentation” or “lipo-implant” and it offers the advantages of both fat grafting and breast implants together:

  • More achievable volume
  • More long-lasting results
  • More strategic contouring
  • Less implant visibility
  • More pronounced cleavage

Limitations of Traditional Techniques for Tuberous Breasts

The issue with using breast implants only to treat tuberous breasts is that they aren’t ideal for the lower and outer aspects breast area. These spots are covered by thin skin with no underlying breast tissue like a normal breast, which means that the breast implants are much more visible when used in these spots.

In the visible cleavage area, the breast implant can be placed under the chest muscle to minimise visibility of the edge of the breast implant, however this often limits the expansion of the medial breast and results in a wide cleavage. The placement under the muscle can also cause a permanent crease on the lower aspect of the breast if the natural breast isn’t fully expanded by the implant.

Another issue with traditional techniques is the use of glandular scoring. While it is a standard part of breast implants, it is a painful process that requires considerable recovery time. There is an increased risk of nerve damage to the nipple with a potential of sensation loss as well as bleeding and haematoma.

In an effort to reduce risk and find a less invasive solution, fat grafting is now being used as a solution to tuberous breasts.

Recovery after Tuberous Breast Surgery – What to expect during recovery from surgery

Corrective cosmetic breast surgery is generally considered safe. But as with any other breast augmentation surgery, your movement will be restricted for some time postoperatively.

Here’s what you need to expect during recovery from tuberous breast reconstruction:

  • Some swelling and puffiness will last up to four weeks after the surgery
  • Some pain and discomfort are expected but they’re easily controlled with oral pain medication
  • At least 1 week of home rest with no work and minimal physical effort
  • You can generally get back to exercising within 3-4 weeks after the surgery
  • Intense cardiovascular activity should be avoided for 12 weeks
  • You might be asked to wear a push-up (surgical) bra for a month after surgery
  • You should sleep on your back for a month after surgery

You can expect to see dramatic improvement immediately after your tuberous breast surgery. However, the final results need around 1-2 months to settle in. By that time, the swelling will be negligible, and the bruising will be gone. Your breast scars will mature over the following few months and will fade into the surrounding skin.

Risks of Tuberous Breast Surgery

All surgery has risks. There are risks and complications of General Surgery and specific risks for Breast Procedures. Dr Turner will explain these risks as part of your consultation and informed consent process. Please visit the Risks of Surgery page for more information about Risks and Complications.

Is Tuberous Breast Surgery Covered by Medicare and Private Health?

Tuberous breast correction surgery is typically covered by Medicare in Australia if yo meet specific criteria. If your Tuberous breasts are considered a breast deformity that requires correction, you could be eligible for a rebate under Medicare item numbers 45528, 45545 and 45060. (There are also two new item numbers for fat grafting from Nov 2021) 

Your surgeon will have to provide photographic evidence and exact measurements to prove the degree of deformity before your request is approved.

Tuberous Breasts FAQs – Questions about Tubular Breast Surgery

  • Can tuberous breasts be fixed naturally? There is no natural way (diet, exercise, creams, lifestyle changes) to fix tuberous breasts. If you have tuberous breasts, the only way to make them look natural and remove the constriction is through reconstructive surgery.
  • Are tuberous breasts inherited? The genetics of tuberous breasts isn’t known yet. At this moment, there isn’t any confirmed genetic component to tubular breasts. If you have tuberous breasts, there’s no evidence that your daughter will be at a greater risk of getting tuberous breasts.
  • Can you breastfeed with tuberous breasts? Yes, in most cases, you can still breastfeed even if you have small tuberous breasts. This is not always the case, though. Women with very little breast tissue may not be able to breastfeed.
  • Will my incisional scars after tubular breast surgery reveal that I previously had tuberous breasts? The incisions used for tubular breast surgery are the same as the ones used in other breast lift operations. The scars will look identical and there will be no way of knowing whether you have had tuberous breasts or not unless you choose to share that information.
  • How common are tuberous breasts? Many women feel like they’re alone in this, but tuberous breasts are more common than you think. Most women feel embarrassed by their condition so they do not share it and hesitate to seek advice or correction. According to one study, more than 90% of asymmetric breasts have features of tuberous deformity.
  • At what age do tubular breasts become noticeable? Most women notice the tuberous appearance of their breasts during puberty. They feel like their breasts look “strange” or “weird” and wait for their bodies to grow out of it. By the time they’re in their early twenties, they realize that their breasts will not improve on their own.

 

Medical References – Further Reading

 

Next Steps – A Consultation with Dr Turner

Are you ready to take the first step in dealing with tuberous breasts?  Visit our clinic to have a consultation with Dr Turner.

It is a great opportunity to learn about all of your options and get a clear vision of what your breasts will look like after corrective surgery

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