Tuberous breast correction

A tuberous breast is a developmental anomaly of the breast, usually becoming noticeable in adolescence as the breasts grow. The base of the breast is narrow, the fold beneath the breast (the inframammary fold) sits higher than usual, and the breast tissue appears pushed towards the areola. The areola is often enlarged and prominent, as if it were “herniated”. The two breasts are frequently asymmetrical in shape or volume.

Tuberous breast correction is a plastic surgery procedure in which the breast gland is reshaped, the inframammary fold is lowered and the areola is reduced. An implant or a transfer of the patient's own fat is often added for volume and shape. At Detalii Med, in Baia Mare, the correction is performed by Dr Marius Pruna and Dr Valeria Pruna.

The procedure is intended for people whose breasts have a tuberous appearance and who are bothered by their shape, volume or asymmetry. The degree of the anomaly varies greatly between patients: some have only a slightly narrow base, while others have obvious changes in one or both breasts.

It is important that breast development is complete and that the patient is in good general health. The right timing is discussed individually with the doctor. A tuberous appearance can also affect self-confidence, and this can be discussed openly at the consultation.

The correction can widen the base of the breast, lower the inframammary fold, reduce the areola and its prominence, and improve symmetry. With an implant or fat transfer, it can add volume where it is lacking.

The procedure cannot create two perfectly identical breasts, because the tissues may differ from the outset. In more marked forms, the result can be a significant improvement but not a breast identical to one without the anomaly. Further stages are sometimes needed, for example another fat transfer for adjustments.

At the consultation, the doctor examines the breasts and assesses the width of the base, the position of the inframammary fold, the size of the areola, the amount of tissue and the differences between the two breasts. The doctor discusses with the patient what bothers her and what result she hopes for.

Based on the examination, the doctor proposes a correction plan: whether an implant, fat transfer or a combination is needed, what type of incisions are required and whether treatment can be done in a single stage. Pre-operative tests, anaesthesia and the recovery period are also discussed. Breast imaging may be recommended where needed.

The procedure is tailored to each case. The surgeon usually uses an incision around the areola, through which its diameter can also be reduced. The breast gland, which is constricted at its base, is released and reshaped so that it can spread over a wider area. The inframammary fold is lowered to a more suitable level.

When volume is insufficient, a breast implant may be placed. Another option, or an addition, is fat transfer: fat is harvested by liposuction from an area of the body, processed and injected into the breast to fill and shape it. The operation usually takes one to three hours.

Tuberous breast correction is usually performed under general anaesthesia, administered by the anaesthetist after a pre-anaesthetic assessment.

After surgery, the breasts may be swollen, tender and bruised for the first few days. Discomfort is usually managed with the recommended medication. The patient wears a surgical bra for the period advised by the doctor. If fat transfer was performed, the area from which it was harvested may also be swollen and tender.

Light activities are usually resumed after about a week. Strenuous exercise and sport are resumed gradually, generally after four to six weeks, with the doctor's agreement. Follow-up appointments are important for monitoring healing.

The risks are discussed at the consultation and include:

• bleeding, haematoma, infection or seroma;
• scars around the areola that are more visible or widen over time;
• changes in nipple sensation;
• persistent asymmetry or partial recurrence of the tuberous shape;
• with an implant: capsular contracture, displacement;
• with fat transfer: absorption of part of the fat, lumps or cysts;
• risks related to anaesthesia.

Later touch-ups are sometimes needed.

The change in shape is visible after surgery, but the final result develops over a few months as swelling settles and the tissues bed in. If the patient's own fat was used, part of it is absorbed in the first months, and the volume usually stabilises after about three to six months.

Scars fade gradually over a year or more. The result may be influenced by weight changes, pregnancies and the passage of time.

A tuberous breast is a developmental anomaly that can be corrected by reshaping the gland, lowering the inframammary fold and reducing the areola, often with an implant or fat transfer. The plan is decided individually at the consultation, according to the shape and volume of each breast, and realistic expectations are essential.