Invited Discussion on: Autologous Fat Grafting with Percutaneous Fasciotomy and Reduction of the Nipple–Areolar Complex for the Correction of Tuberous Breast Deformity in Teenagers

Abstract Tuberous breast deformity refers to a deformity of the breast that is characterized by varying degree of herniation of the breast parenchyma, widened nipple areolar complex, constriction of the breast base and may involve some degree of hypoplasia. Tuberous breast deformity is most often seen in young women who commonly presents due to dissatisfaction with breast symmetry, as this can be a source of significant psychosocial distress. Principles of reconstruction are focused on recreating an aesthetically pleasing breast shape and achieving symmetrization. Traditionally, reconstruction commonly involved utilization of breast implants or local flap to achieve these goals. The introduction of fat transfer has led to a paradigm shift in aesthetic breast surgery. Fat grafting is safe and can reliably achieve satisfactory aesthetic results in selected cases and reduces the need for implants or local flaps. Concepts that reduce scar burden allows for even more satisfactory aesthetic outcomes.

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One-Stage Correction of Tuberous Breast Deformity Using Saline Implants: Without the Need for Radial Scoring or Lowering the Inframammary Fold

The American Journal of Cosmetic Surgery ◽

10.1177/0748806819841466 ◽

2019 ◽

Vol 36 (4) ◽

pp. 191-196

Author(s):

Ted Eisenberg

Keyword(s):

Breast Augmentation ◽

Breast Tissue ◽

Breast Implants ◽

Inframammary Fold ◽

Tuberous Breast ◽

Aesthetic Result ◽

Breast Deformity ◽

Areolar Complex ◽

Tuberous Breast Deformity ◽

The Imf

Tuberous breasts are a congenital anomaly in which the breasts fail to develop normally. This abnormality may include hypoplasia, a tubular appearance, a higher inframammary fold (IMF), and sometimes a herniated nipple-areolar complex. Correction of tuberous breast deformity (TBD) is traditionally done with a 1-stage breast augmentation with radial scoring of the constricted breast tissue and/or the lowering of the IMF. An alternative 2-stage approach first uses a tissue expander to correct the deformity; the expander is later replaced with a permanent breast implant. Sixteen patients are presented in which a 1-stage correction of TBD was successfully accomplished with saline implants acting as tissue expanders. In all cases, the expansion remedied the deformity without the need for radial scoring of the breast tissue or lowering of the IMF. This approach has not been reported in the literature. Sixteen women (32 breasts) were treated, with TBD ranging from mild to severe. All patients had a breast augmentation with round, smooth saline implants placed through an IMF incision in the dual plane (partially subpectoral and partially submammary). Implants ranged in size from 225 cc to 675 cc. The IMF was never lowered and the breast parenchyma was never radially scored. Three patients had asymmetry requiring breast implants of different sizes, and one had a circumareolar mastopexy to repair a herniated areolar complex. Representative case examples are provided. The average follow-up time was 9 months. All deformities were corrected, and the patients expressed satisfaction with their results. There were no occurrences of hematoma, infection, capsular contracture, or malposition. This review has shown that saline breast implants alone, with their inherent expansion capability, can correct TBD without the increased morbidity associated with radial scoring and lowering the IMF. For patients who choose saline implants, this single-stage, less invasive surgical approach can provide a good aesthetic result.

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The Role of Autologous Fat Grafting in Secondary Microsurgical Breast Reconstruction

Senologie - Zeitschrift für Mammadiagnostik und -therapie ◽

10.1055/s-0033-1347551 ◽

2013 ◽

Vol 10 (02) ◽

Author(s):

PN Broer ◽

K Weichman ◽

N Tanna ◽

S Levine ◽

R Allen

Keyword(s):

Breast Reconstruction ◽

Fat Grafting ◽

Autologous Fat Grafting ◽

Autologous Fat

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