Current state of surgical treatment for patients with tubular breast type II (a literature review)

Authors

  • A. A. Kostenko State Institute “Shalimov’s National Institute of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • S. P. Galych State Institute “Shalimov’s National Institute of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • O. Yu. Dabizha State Institute “Shalimov’s National Institute of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • K. A. Samko State Institute “Shalimov’s National Institute of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • D. V. Borovyk State Institute “Shalimov’s National Institute of Surgery and Transplantation of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine

DOI:

https://doi.org/10.14739/2310-1210.2021.1.224962

Keywords:

tubular breast, congenital breast abnormalities, breast surgery, breast reconstruction

Abstract

The aim of the study – to analyze the modern literature, summarize current approaches to surgical treatment of tubular breast type II and identify the causes of poor results.

Tubular breast deformity relates to congenital connective tissue malformations, occurs in puberty and causes a great deal of psychological discomfort to women. The majority of authors note that type II of tubular breast is the most common among patients referred to clinic for a surgical correction.

In fact, the correction of this type of malformation is a reconstructive procedure associated with a number of challenges. The goal of such operation is not only to increase a volume of the breast lower pole, but also to cover the implant maximally using soft tissues to achieve a normal lower pole contour.

To date, a number of surgical techniques have been proposed to address these problems, such as C. Puckett and M. Concannon (1990), L. Ribeiro (1998), E. Muti (1996), A. Mandrekas (2003) and their modern modifications. Fat grafting techniques in treatment of tubular breast are also getting popular, but all have some drawbacks.

Conclusions. A high level of complications and the absence of a universal method for correction of tubular breast type II are preconditions for improving the surgical technique to correct this pathology.

References

Mandrekas, A. D., Zambacos, G. J., Anastasopoulos, A., Hapsas, D., Lambrinaki, N., & Ioannidou-Mouzaka, L. (2003). Aesthetic Reconstruction of the Tuberous Breast Deformity. Plastic and Reconstructive Surgery, 112(4), 1099-1108. https://doi.org/10.1097/01.prs.0000076502.37081.28

Galich, S. P., & Pinchuk, V. D. (2009). Esteticheskaya khirurgiya grudi. Rukovodstvo dlya vrachei [Aesthetic Breast Surgery. A Guide for Physicians]. Kyiv. [in Russian].

Mandrekas, A. D., & Zambacos, G. J. (2009). Aesthetic Reconstruction of the Tuberous Breast Deformity. In M. A. Shiffman (Ed.), Breast Augmentation (pp. 307-319). Springer. https://doi.org/10.1007/978-3-540-78948-2

Costagliola, M., Atiyeh, B., & Rampillon, F. (2013). Tuberous Breast: Revised Classification and a New Hypothesis for its Development. Aesthetic Plastic Surgery, 37(5), 896-903. https://doi.org/10.1007/s00266-013-0124-2

Klinger, M., Caviggioli, F., Klinger, F., Villani, F., Arra, E., & Di Tommaso, L. (2011). Tuberous Breast: Morphological Study and Overview of a Borderline Entity. Canadian Journal of Plastic Surgery, 19(2), 42-44. https://doi.org/10.1177/229255031101900210

Oroz-Torres, J., Pelay-Ruata, M. J., Escolán-Gonzalvo, N., & Jordán-Palomar, E. (2014). Correction of Tuberous Breasts Using the Unfolded Subareolar Gland Flap. Aesthetic Plastic Surgery, 38(4), 692-703. https://doi.org/10.1007/s00266-014-0340-4

Muti, E. (1996). Personal approach to surgical correction of the extremely hypoplastic tuberous breast. Aesthetic Plastic Surgery, 20(5), 385-390. https://doi.org/10.1007/BF02390312

Delay, E., Sinna, R., & Ho Quoc, C. (2013). Tuberous Breast Correction by Fat Grafting. Aesthetic Surgery Journal, 33(4), 522-528. https://doi.org/10.1177/1090820X13480641

Grolleau, J. L., Lanfrey, E., Lavigne, B., Chavoin, J. P., & Costagliola, M. (1999). Breast Base Anomalies: Treatment Strategy for Tuberous Breasts, Minor Deformities, and Asymmetry. Plastic and Reconstructive Surgery, 104(7), 2040-2048. https://doi.org/10.1097/00006534-199912000-00014

Versaci, A. D., & Rozzelle, A. A. (1991). Treatment of tuberous breasts utilizing tissue expansion. Aesthetic Plastic Surgery, 15(4), 307-312. https://doi.org/10.1007/BF02273878

Kolker, A. R., & Collins, M. S. (2015). Tuberous Breast Deformity: Classification and Treatment Strategy for Improving Consistency in Aesthetic Correction. Plastic and Reconstructive Surgery, 135(1), 73-86. https://doi.org/10.1097/PRS.0000000000000823

Innocenti, A., & Innocenti, M. (2015). Retro-Areola Distally Based Flap in the Management of the Full Expression of Tuberous Breast: A Simple Strategy to Resolve a Weak Point of the Deformity. Aesthetic Plastic Surgery, 39(5), 700-705. https://doi.org/10.1007/s00266-015-0539-z

Somogyi, R. B., & Brown, M. H. (2015). Outcomes in Primary Breast Augmentation: A Single Surgeon’s Review of 1539 Consecutive Cases. Plastic and Reconstructive Surgery, 135(1), 87-97. https://doi.org/10.1097/PRS.0000000000000773

Zambacos, G. J., & Mandrekas, A. D. (2006). The Incidence of Tuberous Breast Deformity in Asymmetric and Symmetric Mammaplasty Patients. Plastic and Reconstructive Surgery, 118(7), 1667. https://doi.org/10.1097/01.prs.0000244312.37791.c8

Nahabedian, M. & Neligan, P. (Eds.). (2018). Plastic surgery. Volume 5: Breast (4th ed.). Elsevier.

Kumar, B. A., & Hodgkinson, D. J. (2009). Periareolar Technique for Correction and Augmentation of the Tuberous Breast. In M. A. Shiffman (Ed.), Breast Augmentation (pp. 321-328). Springer. https://doi.org/10.1007/978-3-540-78948-2

Ellart, J., Chaput, B., & Grolleau, J. L. (2016). Seins tubéreux [Tuberous breast: Current concept]. Annales de Chirurgie Plastique et Esthetique, 61(5), 640-651. https://doi.org/10.1016/j.anplas.2016.08.003

von Heimburg, D. (2000). Refined Version of the Tuberous Breast Classification. Plastic and Reconstructive Surgery, 105(6), 2269-2270. https://doi.org/10.1097/00006534-200005000-00068

Foustanos, A., & Zavrides, H. (2006). Surgical reconstruction of tuberous breasts. Aesthetic Plastic Surgery, 30(3), 294-300. https://doi.org/10.1007/s00266-005-0180-3

Silva-Vergara, C., Fontdevila, J., & Weshahy, O. (2018). Fat Grafting Technique, A Paradigm Shift in the Treatment of Tuberous Breast. World Journal of Plastic Surgery, 7(1), 72-77.

Rees, T. D., & Aston, S. J. (1976). The Tuberous Breast. Clinics in Plastic Surgery, 3(2), 339-347. https://doi.org/10.1016/s0094-1298(20)30232-7

Puckett, C. L., & Concannon, M. J. (1990). Augmenting the narrow-based breast: The unfurling technique to prevent the double-bubble deformity. Aesthetic Plastic Surgery, 14(1), 15-19. https://doi.org/10.1007/BF01578320

Galych, S. P., Dabizha, O. Y., Kostenko, A. A., Gomolyako, I. V., Samko, K. A., & Borovyk, D. V. (2016). Surgical Treatment of Tubular Breast Type II. Plastic and Reconstructive Surgery - Global Open, 4(10), Article e1024. https://doi.org/10.1097/GOX.0000000000001024

Ribeiro, L., Canzi, W., Buss, A., Jr., & Accorsi, A., Jr. (1998). Tuberous Breast: A New Approach. Plastic and Reconstructive Surgery, 101(1), 42-52. https://doi.org/10.1097/00006534-199801000-00008

Mandrekas, A. D., & Zambacos, G. J. (2010). Aesthetic reconstruction of the tuberous breast deformity: a 10-year experience. Aesthetic Surgery Journal, 30(5), 680-692. https://doi.org/10.1177/1090820X10383397

Hilal, H., & Sadek, E. (2018). Periareolar Approach for Correction of Bilateral Asymmetric Tuberous Breasts. Egyptian Journal of Plastic and Reconstructive Surgery, 42(2), 265-272. https://doi.org/10.21608/ejprs.2018.79709

Serra-Renom, J. M., Muñoz-Olmo, J., & Serra-Mestre, J. M. (2011). Treatment of Grade 3 Tuberous Breasts with Puckett’s Technique (Modified) and Fat Grafting to Correct the Constricting Ring. Aesthetic Plastic Surgery, 35(5), 773-781. https://doi.org/10.1007/s00266-011-9686-z

Golovatch, V. A., & Borovikov, A. M. (2013). Dvoinaya skladka. Tubulyarnost' - ne glavnoe [Double-bubble deformity. Tubularity is not principal]. Plasticheskaya khirurgiya i kosmetologiya, (4), 523-536. [in Russian].

Rigotti, G., & Chirumbolo, S. (2019). Biological Morphogenetic Surgery: A Minimally Invasive Procedure to Address Different Biological Mechanisms. Aesthetic Plastic Surgery, 39(7), 745-755. https://doi.org/10.1093/asj/sjy198

Tonnard, P., Verpaele, A., Peeters, G., Hamdi, M., Cornelissen, M., & Declercq, H. (2013). Nanofat Grafting: Basic Research and Clinical Applications. Plastic and Reconstructive Surgery, 132(4), 1017-1026. https://doi.org/10.1097/PRS.0b013e31829fe1b0

Khouri, R. K., Jr., & Khouri, R. K. (2017). Current Clinical Applications of Fat Grafting. Plastic and Reconstructive Surgery, 140(3), 466e-486e. https://doi.org/10.1097/PRS.0000000000003648

Hivernaud, V., Lefourn, B., Guicheux, J., Weiss, P., Festy, F., Girard, A. C., & Roche, R. (2015). Autologous Fat Grafting in the Breast: Critical Points and Technique Improvements. Aesthetic Plastic Surgery, 39(4), 547-561. https://doi.org/10.1007/s00266-015-0503-y

Geissler, P. J., Davis, K., Roostaeian, J., Unger, J., Huang, J., & Rohrich, R. J. (2014). Improving Fat Transfer Viability: The Role of Aging, Body Mass Index, and Harvest Site. Plastic and Reconstructive Surgery, 134(2), 227-232. https://doi.org/10.1097/PRS.0000000000000398

Published

2021-04-07

How to Cite

1.
Kostenko AA, Galych SP, Dabizha OY, Samko KA, Borovyk DV. Current state of surgical treatment for patients with tubular breast type II (a literature review). Zaporozhye Medical Journal [Internet]. 2021Apr.7 [cited 2024Dec.2];23(1):146-51. Available from: http://zmj.zsmu.edu.ua/article/view/224962

Issue

Section

Review