Objectives: Tuberous breast (TB) can appear with a wide range of clinical findings poses a challenge to consistency in nomenclature and surgical correction. Due to this polymorphism epidemiological data show a wide discrepancy in the literature. Minor forms are easily confused with normal anatomical breasts. The aim of this article is to focus the peculiar pathologic hallmarks of each type of deformity and to propose a one-step reconstructive algorithm tailored on the distinctive breasts characteristics, through the concept of volume displacement according with the different types of TBs deformity
Introduction: TB deformity is a congenital malformation appearing during puberty, with a wide spectrum of anatomical presentations. The deformity is widely variable among the affected patients, showing very different clinical appearances but despite this, wider intermammary space, breast base constriction, cranialization of the inframammary fold and areola’s disorders are always present as common hallmarks. Due to the multitude of variants in which TB could appear, a reconstructive algorithm could help to assess all features that affects the breast to plann the most appropriate surgical strategy.
Materials / method: From September 2006 to December 2019, 118 patients have been treated for TB deformity in one-step procedure using tailored local flaps according to the preoperatively assessed clinical variant. Minimum follow-up was 12 months. All the procedures were performed under local anesthesia.
Results: A total of 220 TBs (98 hypoplastic and 122 normoplastic) were treated. Patients' mean age was 20.2 years.
Mean follow-up was 36.5 months. Six minor complications (capsular contracture and nipple-areolar-complex
hypoesthesia) and no major complications have been reported. In 9% of cases, minor secondary procedures,
including lipofilling, scar revisions and breast implant substitution, have been performed.
Conclusion: TB correction requires careful identification due to the complexity of its pathological hallmarks, after which
a preoperative planning and a surgical strategy can be assessed. The proposed algorithm, including a
comprehensive classification, preoperative planning and surgical approach derived from authors’ experience,
could help in tailoring the most appropriate surgical approach for each type of tuberous breast deformity.
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