Are constricted breasts the same as tuberous breast deformity, a congenital anomaly? (Photos)

Question

35 yo female, never pregnant. I saw a PS yesterday who told me I had constricted breasts, one more severe than the other, both affected and quite ptotic for never having children. Is this the same as tuberous breast deformity, a congenital anomaly? Do you agree with this diagnosis? If so, I am looking for a surgeon who is experienced with remedying this issue through augmentation. I would also like areola reduction.

Chul Hwan Seul, MD, PhD · Answer

Tuberous breast deformity is a type of severe constricted breast deformity when breast the shape is tubular. However, in your case it seems to be milder example of constricted breasts (not yet tuberous). Your areolas are wide and there is visible breast ptosis, therefore I would recommend peri-areolar mastopexy (breast lift) and breast augmentation with implant. For the most satisfying and natural effect I also recommend getting fat grafting in the wide intermammary span.

Alexander Zuriarrain, MD, FACS · Answer

Hello and thank you for your question. Based on the photographs I would recommend an evaluation with a board-certified plastic surgeon that is going to measure you accurately. Tuberous breast and constricted breast deformity is the same by definition. This is a congenital anomaly produced from birth. I do agree with the diagnosis. This can easily be corrected by performing a breast augmentation above the muscle, scoring the breast gland from the inside to release the contracture bands that caused the tuberosity, reduce the areola circumference and lift the breast. All of this can be done in a single operation and can provide excellent results.
Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

David Branch, MD · Answer

Futurerose, you have mildly constricted breasts or a very mild form of tuberous breast, and some size asymmetry. for your best results, I would recommend bilateral areolar reductions with a small reduction on the right followed by bilateral breast augmentation at 3-6 months to expand the base of both breast. Alternatively, bilateral breast fat grafting can be done with the areolar reductions for about 1/2 cup size increase, or the augmentation could be done at the same time with a little higher revision rate, as there will be more tension on your breast incisions. Hope this helps!

Gary M. Horndeski, MD · Answer

Your breasts are asymmetrical in volume, shape and position. Implants alone will only add volume. The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed for additional volume.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Schwartz, MD · Answer

Your photos show a variation of tuberous breast syndrome, in which the breast tissue develops in a more narrow or constricted location behind the areolae.  The breasts never develop the usual round outline.  Patients lack normal fullness in either vertical or horizontal directions, or even both.  The constricted breast tissue bulges forward pushing the areolae outward.   The usual surgery requires implant placement and rearrangement of your own breast tissue in all directions (release of the constriction), along with areolar reduction.  Different sized implants are often necessary to even out any size discrepancy.   Although this sounds like a lot of work, I have seen very nice results in my patients.

Daniel Barrett, MD · Answer

Dear Futurerose,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

It does appear you have some constriction of the breasts.  A breast lift with implants would help raise the position of the nipple, improve symmetry and give you more upper pole volume.  As part of the procedure the areola would be downsized to be in better harmony with the rest of the breast.

Williams Bukret, MD · Answer

Agree with the diagnosis of tuberous breast deformity. A breast lift with implants and areola reduction, conserving breast glands, will be the best approach for your condition.

Thomas G. Korkos, MD · Answer

By definition, tuberous breast deformity involves constriction of the inframammory fold, as well as herniation of breast tissue through the areola. Looking at your pictures, you have elements of it. Your operation would involve augmentation in a sub-pectoral position, release of the inframammory fold with radial scoring, and reduction of the areola diameter. In the end, you'd look spectacular. I've seen many of these in my 26 year career.

Kelly Killeen, MD, FACS · Answer

Hello!  Yes tuberous breast and constricted breast are the same thing.  I do agree with the plastic surgeon you saw that you have this as well.   Corrective surgery for this is more complicated than a simple breast augmentation, you will need release of the constricted areas internally as well.  Areolar reduction can be done at the same time as the augmentation (this is done with a breast lift of various types depending on your degree of loose skin).  The best procedure really depends on what your size goal is.  Augmentation with lift +/- fat grafting or lift/reduction with fat grafting would both give great results depending on what your goal size is.  Fat grafting is very helpful in widening the base of your breast to give a more natural appearance in with tuberous patients as well.  It is also worth mentioning that insurance occasionally covers tuberous breast reconstruction.  I would recommend at least trying to submit and see if they would assist you in cost.  Good luck!

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