If breasts are narrow at the bottom and protruding out like snoopy’s nose they are what is classified as Tuberous breasts. This type of breast shape is reported in 5% of patients but the exact incidence isn’t known. Tubular breast deformity can occur in men and women. Originally classified in three grades of severity a few typical characteristics are present. First like the name states the breast has elongated tubular appearance. Most often this is due to a shortage and tightness to the tissues only the lower half of the breast. This is why tubular breasts are also called “constricted” breast for the tighter lower portion of the breast narrows to the base of the breast. This constriction tends to make for a higher inframammary crease which is where the breast joins the chest wall. Typically the distance from the nipple to the inframammary crease (IMC) is shorter than normal. Also, this constriction of breast tissue leaves a wider than normal spacing between the two breasts. The patients Areola and nipple may look like its being pushed out from the breast and frequently it may a bit large relative to the rest of the breast. Patients with constricted breast deformities may have a lower chance to breast feed than the general population, but this has not been formally studied.
So what can be done to assist the patient in managing the tubular breast? Breast Augmentation with tissue scarring is the mainstay of addressing tubular breast deformity. Tissue “scarring” means the surgeon will make some cuts into the breast tissue to allow it to relax and stretch quicker with the breast augmentation. How much “scarring” depends on the tightness of the native breast.
As mentioned earlier tuberous/tubular breasts can have an enlarged areola that is pushing out from the breast. To create a better contour to the breast a “donut” mastopexy might be needed as well as the breast tissue scarring. A donut mastopexy or some variant means we remove a donut shape of the extra areola skin to make it an appropriate size. Also, releasing the breast from the overlying skin permits I to push the herniating breast/areola tissue back in so it doesn’t look like snoopy’s nose anymore. If the tubular deformity is mild it might be suggested to hold off on the mastopexy to see if after augmentation is even needed. Frequently a donut mastopexy can be done under local anesthesia down the road if needed.
Occasionally a patient might have a severe enough deformity that a tissue expander could be suggested. Tissue expanders allow the surgeon to stretch out your breast tissue over time by adding salt water (saline) solution into a type of breast implant expander made for this purpose. Tissue expanders are commonly used in breast cancer reconstruction. The need for the expander is rare for tuberous breast issues. There are expandable implants that can serve as your expander and a final implant. However in my opinion, in the very rare patient that an expander is utilized the end result is better & the expander is changed out for a more standard implant after the expansion process is finished. We hope this sheds some light on tuberous/tubular breast deformity. Feel free to contact us at 520-575-8400 for an appointment for a personal assessment.