Congenital deformities of the breast

Congenital breast anomalies include supernumerary nipples (polythelia) and supernumerary breasts (polymastia) which can be generally found on the embryonic mammary ridge. Absence of the breast occurs less frequently and varying presentations of absence of nipples only (athelia), absence of mammary gland tissue (amazia), or absence of the entire breast (amastia). Tuberous breast deformity is a common congenital anomaly with varying degrees of constriction, hypoplasia, areolar herniation, skin deficiency, and asymmetry. Treatment consists of breast augmentation, either primarily or after tissue expansion, in combination with mastopexy. Gynaecomastia is the development of breast tissue in males. The aetiology is diverse and includes physiological, pathological, acquired, drug-related, and idiopathic causes. Poland syndrome is discussed elsewhere (Chapter 9.2).

Asymmetry of the breast

Developmental breast asymmetry is common in women and may be associated with significant psychological distress. It may be due to deformity of the breast itself (true) or secondary to abnormalities of the underlying torso (apparent). True breast asymmetry may be congenital or acquired. This chapter gives an overview of the aetiology and classification of developmental breast asymmetry and discusses the clinical evaluation of women presenting with breast asymmetry. Congenital breast asymmetry, subdivided into hypoplastic, hyperplastic, and deformational, is discussed. The abnormalities and challenges specific to Poland syndrome and tuberous breast deformity are described. For each subdivision, the surgical techniques available to correct the deformity are reviewed. The limitations of surgery and potential outcomes are discussed.