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Tuberous breast surgery

Breast surgery

Tuberous breasts constitute a quite common mammary malformation, with an undetermined cause. It appears from puberty during the breast development. This malformation results in deep social as well as psychological discomfort, and affects the feminity of these young women.

It is steadily characterized by a breast base anomaly, whose growth is done solely towards the center of the breast. This development defect at the periphery of the breast is responsible for their tuberous shape in severe forms (in the shape of tuber).
Other defects are possible and represented by:

A high position of the inframmary folds, which also contributes to the decrease of the breast base (in most cases).
Large areolae
An areolar protrusion (bulging of the areola relating to a hernia of the la mammary gland through the areola).
An insufficient breast volume (breast hypotrophy) in most cases. However, the breasts can be at their normal volumes, or even undersized.
A breast asymmetry (in most cases).

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Objectives
Procedure steps
Tuberous breast surgery
General pre-operative instructions
Specific pre-operative instructions
Procedure stages
after surgery
Procedure risks
Long-term result

Tuberous breast surgery objecives

Tuberous breast surgery has three main objectives:

To enlarge the breast base in order to create a natural rounded shape.
To increase and/or redistribute the breast volume in the deficient segments.
To reposition and to reduce the areolae size.

This procedure can be achieved from the end of the pubertal period (end of the breast development).

Procedure steps

Dr. Petit will begin with questioning your medical history as well as your family history of breast cancer, your bra size, your weight and your size, as well as your tobacco consumption.
He will listen to you in order to understand your discomfort and your expectations relating to the shape and the volume of the breasts.
He will suggest the most appropriate surgical strategy corresponding to your anatomy and your request.
He will carry out a clinical examination of your breasts in order to define the grade (degree of severity) of your malformation.
Dr. Petit will provide information on the scar positioning, treatment process and procedure limits, post-operative recoveries as well as main risks, so as to make an informed decision.

Good candidates for tuberous breast surgery are those

With tuberous breasts, undersized in most cases, with large areolae, or even protruding out.
Accepting scars.
And having understood the specific risk of this surgery, namely a poor achievement requiring a secondary surgical revision.

General pre-operative instructions relating to aesthetic surgery

Smoking cessation 1 month before and after the procedure.
Discontinuation of medicines which increase bleeding 10 days before and after the procedure: aspirin, anti-inflammatory and anticoagulant medicines, vitamin E.

Specific pre-operative instructions relating to the breast reduction

To do a mammography to return on the day of surgery.

Procedure stages

Pre-operative markings are performed by Dr. Petit before the operation.

The operation is achieved under general anesthesia, with an out-patient basis (hospital discharge that very evening) or with hospitalization of one night at the clinic according to the cases.

The 3 principles of undersized tuberous breast surgery are:

The lowering of the inframammary folds to enlarge the breast base.
The increase of the breast volume by placing breast implants and/or by achieving a lipofilling surgery.
The rise and the decrease of the areolae size by performing a cutaneous plastic surgery, combining a periareolar scar (circumareolar) and a vertical scar under the areola.

When tuberous breasts are at their normal volumes or are hypertrophic, the techniques used are respectively breast lift surgery and breast reduction, with scars in the shape of an anchor.

The skin closure is performed with subcutaneous resorbable sutures.

A dressing modeling the breasts is performed at the end of the procedure.

What to expect after surgery

Pains depend on the operative gestures performed. Pains are well soothed by analgesics.

Ecchymosis (bruises) can subside within 2 weeks after the operation. An oedema (swelling) is constant and of variable duration, gradually subsiding within a few months.

Daily nursing care after your shower with a soft soap is necessary during 10 to 15 days.

The wearing of a support bra without any underwiring is recommended day and night during 1 month.

The resumption of daily activities is possible the day following the procedure.

The resumption of professional activities is possible 1 to 2 weeks following the procedure.

The resumption of sports activities can be done from 4 to 6 weeks following the operation.

Procedure risks

The risks concerning tuberous breast surgery are weak.

It implies the main risks relating to plastic surgery and breast enlargement surgery.

The specific risk of tuberous breast surgery is a poor achievement, which results in:

residual asymmetries.
The occurence of a double fold (a double contour aspect) in the lower pole of the breast during a breast enlargement surgery by placing implants.
A recurrence of the areolar protrusion (bulging of the areola).

All these defects may involve a secondary surgical operation.

Long-term result

The final result of tuberous breast surgery is obtained between 3 to 6 months after the procedure, when the post-operative oedema has disappeared. Your breasts will gradually regain their natural shape during this period.

The scars initially are inflammatory (red and swollen) the first months, then they will fade gradually without disappearing. The final aspect of your scars is not predictable and will be known at the end of the scarring maturation (between 1 and 2 years after the procedure).

The result is stable and long-lasting except in case of significant changes in body weight or pregnancy. However, your new breasts will evolve like any uncorrected woman subject to the effects of gravity and ageing.

This procedure is highly appreciated by patients, owing to significant improvement of the breast volume and shape.

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