Tuberous Breasts
The various names it is given are descriptors of the deformity, they include: snoopy breast, conical breast, tubular breast, as well as the more technical, lower pole hypoplasia.
The condition was not described in detail until 1974, though it must have existed as long as there have been women. It varies in degree, but essentially one or both breasts are severely underdeveloped in bulk but may have a normal or even enlarged areola and nipple.
Observations of the abnormality have included: contracted skin envelope; constricted breast base; reduction in breast parenchyma; elevation of inframammary fold.
It has been classified in degree in various ways, a simple and practical one for planning treatment is that of Grolleau:
There is no evidence of a familial tendency. The explanation is given by some that tight fascia has constricted the development of the breast, but since the breast is essentially a skin structure, superficial to the deep fascia, it is hard to accept that explanation.
There is no valid treatment except surgery, which may possibly require:
- Type I: Hypoplasia of the lower medial quadrant.
- Type II: Hypoplasia of both lower quadrants.
- Type III: Hypoplasia of all four quadrants.
- Reduction of areolar hypertrophy.
- Increase the skin volume in the breast lower pole.
- Take down the infra mammary fold.
- Expand the glandular parenchyma.
- Increase the breast volume by prosthesis.
This case depicts a 24 year old woman with a tuberous breast deformity who underwent breast augmentation with 330 cc smooth, round, saline implants placed beneath the pectoralis muscles via a periareolar approach.
Her areolas were reduced simultaneously, necessitating an incision completely around the perimeter of the areola.The post-operative photographs depict her appearance at two weeks after surgery.
Dr. Belsley's Philosophy of Breast Augmentation
When it comes to deciding what approximate breast size you wish to achieve, the best advice I can give you is that you should be guided by your physical frame. Indeed, you may in fact be limited by it. In my practice, I select implants based upon your chest measurements, the quality of your breast skin and the size of your breasts prior to surgery.
I perform breast augmentation through a peri-areolar or inframammary approach and I place that vast majority of implants at least partially beneath the pectoralis muscle. My patients are welcome to select either saline or silicone filled breast implants. Silicone filled implants can in some cases achieve a more natural feel and may be a particularly attractive option for women with less breast tissue prior to surgery.
More >>Dr. Belsley's Philosophy of Breast Lift (Mastopexy)
In my practice, I perform breast lifts using incisions that result in a “lollipop” shaped scars. With good care and a bit of luck, these incisions heal well and the scars are difficult to see from a distance. Nevertheless, a woman who undergoes a cosmetic breast lift must be prepared for scars that are visible. This is one example of a “trade-off” in plastic surgery and of course, there are many others. This is one, however, that I feel is more than worthwhile in appropriate candidates.
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