What are the different types of tuberous breasts

Breast shape, size, symmetry and nipple size are common insecurities in women. Many seek cosmetic surgery to correct these, such as breast augmentation, breast lift or breast reduction. Still, it is essential to identify a tuberous breast deformity if you want aesthetic surgery.

Tubular or tuberous breasts result from developmental complications in the womb, but this only becomes apparent during puberty. The deformity is typically characterised by a conic or tubular shape, breast hypoplasia (underdevelopment) horizontally and vertically and protrusion of the nipple and areola. A unique surgical approach is required to correct tubular breasts, so you must go to a specialist surgeon if you want tubular breast surgery.

This article discusses the features of tubular breasts and the defined types and grades of breast deformities. Then we discuss the possible correction options for tuberous breast deformities.

What are the features of tuberous breasts?

Tuberous breasts are diagnosed symptomatically. However, every case can display a unique set of characteristics. The typical features of tuberous breasts are as follows:

• Small breast base

• The tubular, conic or cylindrical shape

• Large, protruding nipples/areolas

• Wide-set breasts

• Deficiency in tissue volume

• Droopy breasts or downward-pointing breasts

• Elevated inframammary fold

• Underdevelopment in the lateral and lower portions of the breasts

• Breast asymmetry

• Peripheral breast constriction

Some symptoms do not always suggest a tubular breast deformity; this can be confirmed at your consultation.

What are the different grades of tuberous breasts?

The types of tuberous breasts are also categorised by the presence of specific symptoms. The condition is graded according to the kind of deformity and the severity of asymmetry. There are four or five types of tuberous breasts and three grades of asymmetry.

Type I

This is the mildest tuberous deformity and is characterised by the following:

• Underdevelopment in the lower and inner portions of the breast

• Breasts usually have normal volume

• Wide-set breasts

• Potentially outward-pointing breasts /nipples

Type II

This type of tuberous breast deformity is more severe and is characterised by the following:

• Underdevelopment in the outer, inner and lower portions of the breast

• Conic or oval breast shape

• Slight drooping of the breasts

• Slight deficiency in breast volume

Type III

Again more severe than type II, the type III breast deformity is characterised by the following:

• Underdevelopment in the outer, inner and lower portions of the breast

• Deficiency of skin and tissue under the areola

• Nipples/areolas may sit very low in the breast

• Droopy breasts

• Oval, conic or cylindrical shape

• Large, bulging (herniated) areolas & nipples

Type IV

This type is not characterised by underdevelopment or skin deficiency but by the following characteristics:

• Small breast base

• Constricted breast development

• Large, bulging (herniated) areolas & nipples

• Cylindrical/oval shape

Type 0

Another type of tuberous breasts was later proposed; this type does not display many characteristics of the other types. Type 0 is characterised by herniation of the Nipple-Areolar-Complex (NAC) with a normal breast base. You may have type 0 if you have the following:

• Large, bulging (herniated) areolas & nipples

• Normal breast volume

• Normal breast shape

Grades of breast asymmetry

Another way that tubular breasts are assessed is by the degree of breast asymmetry. There are three grades, mild, moderate and severe which relate to the difference in breast volume.

• Mild asymmetry – less than 200g difference between right and left breast

• Moderate asymmetry – between 200g and 400g difference

• Severe asymmetry – over 400g difference between right and left breast

Types of tuberous breast correction

Your surgeon will assess your condition and suggest the best cosmetic surgery approach for fixing tuberous breasts. These deformities usually require the following surgery:

1. Disturbance of the constricting fibrous ring releases the breast parenchyma to form a new shape. This is required for types II & III.

2. Breast tissue remodelling – breast tissue must be reconstructed in most cases to create a natural breast shape. Breast tissue is usually folded to fill the lower quadrant of the breast (types I, II, III & IV). Tissue around the nipple and areola frequently needs reducing in types III, IV & 0.

3. Tissue expanders – small or severely deformed breasts (types III & IV) may require a tissue expander to encourage the skin and connective tissue to stretch to fit the breast implants.

4. Breast implants – if the patient desires more breast volume, the plastic surgeon can perform breast augmentation using implants. These will give fullness to all quadrants of the breast. This is particularly useful for women with breast asymmetry or type II, III or IV deformities.

5. Areola reduction – a doughnut-shaped incision can be made around the areola to reduce its size. This is appropriate for type III, IV & 0 deformities

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6. Male breast reduction is also possible for gynaecomastia or male tubular breasts.

Sources

• Tuberous Breasts: A Periareolar Approach

• The tuberous breast deformity: classification and treatment

• Tuberous Breast: Revised Classification and a New Hypothesis for its Development

• Review of Tuberous Breast Deformity: Developments over the Last 20 Years