How is the releasing of lower pole constriction for tuberous breasts actually performed?

Question

Most specifically, where is the incision made to perform the scoring? If the candidate has large areola (e.g. 2.5in diameter) could this potentially be performed through a periareola incision to release the lower pole? I'm curious if there are some cases where it is possible to correct tuberous breasts with only a periareola scar, or whether an inframammary crease is usually needed too after areola correction.

Anthony Deboni, MD · Answer

Thank you for your question.  It is difficult to give advise on your particular case without photos, but I can make some general comments.  With a tuberous/constricted breast, the lower pole of the breast below the areola is typically tight and requires release. Many times, an implant is placed as well.  Most surgeons will approach a constricted breast through a peri areolar incision as it allows the best access to score and release the lower pole constriction, and reduce the areolar size and herniation.  Usually, an infra mammary incision is not needed.  A consult with a board certified plastic surgeon who can asses your specific concerns is the best next step. Best Regards.

John Mesa, MD · Answer

Tuberous breast consist int hat the breast gland is constricted itself,t his givign a "see potato-like" shape to the breast. In order to correct a tuberous breast, the breast tissue has to be cut it its center so it opens up like a blossoming flower to give space to the breast implants that is usually placed right after. the Even though breast implants can be placed through different approaches, is the inframammary incision access the one that allows more control of the breast tissue to correct the constriction of the tubular breasts, compare with the other techniques.

Guy Watts, MBBS (Hons), FRACS (Plast) · Answer

Thank you for your question. Yes it is possible to complete a tuberous breast surgery and radial scoring as you have mentioned through a periareloar approach. Given the size of your areolar that does not sound unreasonable. An incision in the inframammary crease is not always required but some surgeon may prefer the access for varied reasons. I hope that helps.RegardsDr Guy WAtts

Tom J. Pousti, MD · Answer

Thank you for the question. Yes,  I utilize the infra areolar  approach for the majority of patients undergoing breast augmentation surgery and correction of constricted/tuberous breasts. This infraareolar approach does provide for good exposure and allows for good visualization for the radial incisions used to "round out" the lower breast poles.  An infra areolar incision is not necessary. For some patients with constricted/tuberous breasts, reducing areola size and/or "puffiness" is also done, depending on the patient's goals/concerns.  This requires an incision all the way around the areola. I hope this, and the attached link, helps. Best wishes.

Marc J. Salzman, MD, FACS (retired) · Answer

In my experience, I prefer the peri-areolar incision for the correction of the tubular breast.  Three techniques  need to be accomplished in order to correct this deformity. The bottom third of the breast needs to be scored radially to allow it to expand,  the crease needs to be lowered but still attached from its dermis to fascia so as to not produce a double bubble, and the muscle needs to be released usually to a level at the top of the areola and then the breast released off of the bottom of the pectoralis muscle such that the muscle can window shade upward forcing the implant downward. I hope this is not too technical but it does answer your question. Good luck.

How is the releasing of lower pole constriction for tuberous breasts actually performed?

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