Our plastic surgeon who specializes in breast reconstruction has recommended that our 18 yr old with this condition have mastoplexy first, followed by breast implants at a later date.
What will mastoplexy accomplish for a patient who has tuberous breasts?
Doctor Answers 7
The mastopexy part of the procedure is to properly position the nipples and areolas, and to reduce the areolar diameter.The implant is to add volume. I think most surgeons would prefer to do these at the same stage in this setting, but it would be on a case by case basis, since each patient with tuberous breast is different.
Your first consultant may have a good plan, but I would recommend seeking other opinions. All the best.
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One Stage Augmentation / Mastopexy is Usually the Best Option
Over the years I have helped many patients with tuberous breast issues. This problem often causes a lot of emotional distress for women and presents along a spectrum with some cases being much worse than others.
In general, I find that volume addition with an implant, combined with skin tightening and areolar reduction via a mastopexy (in one stage) usually provides an excellent improvement. Sometimes a portion of the excess breast tissue behind the areola is also removed in order to change a "pointy" breast into a rounder breast. Often the mastopexy is a circumareolar mastopexy leaving only a circular scar around the areola.
Clearly each case needs to be evaluated individually, because there are always exceptions to the rules. However, I have found that the techniques I mentioned above have worked well for the majority of patients I have treated for this issue.
Mastopexy (breast lift) for Tuberous Breasts?
While a mastopexy (breast lift) may have been recommended for you, it may not have been recommended for the tuberous aspects of your breast. A "tuberous" or narrow breast can also be addressed with simply an augmentation through an incision under the breast to "open" the breast base to accommodate an implant. At 18 years of age, it would be a shame to put scars on the breast that don't need to be there if tuberous breasts are the only issue that need to be addressed prior to placement of implants. I would recommend a second consultation to clarify this or even a second opinion elsewhere as the breast lift may be needed for other issues (breast/areolar droop).
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You need another consultation
The purpose of the visit with your plastic surgeon was to have your questions answered, obviously that did not happen. You should seek another consultation. Many of us do mastopexys and implants at the same time, saving a patient a second surgery, but without seeing what the problem is, it is impossible to tell you what is right.
Without seeing pictures or seeing her in person, it is impossible to give specific advice or recommendations. However, surgery for tuberous breasts needs to be customized to the patient. Often this involves a combination of mastopexy and augmentation which can be performed together or in stages.
Tuberous breasts and mastopexy
There are many variants of tuberous deformities. Often there is little breast tissue on a narrow base and soemtiems herniating tissue through the areola. An implant is often used with variations of mastopexy type techniques.
Tuberous Breast Surgery Options?
Thank you for the question.
Tuberous (constricted) breasts may present in a variety of different forms. For this reason, it is not possible to give you precise advice without direct examination or viewing pictures.
Generally speaking, the majority of patients who present with tuberous (constricted) breasts in our practice have been able to undergo a single stage reconstructive procedure.
Again, generally speaking,correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.
In the most severe cases of tuberous breast, a more complete breast lift may also be necessary. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.
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