Current state of surgical treatment for patients with tubular breast type II (a literature review)
DOI:
https://doi.org/10.14739/2310-1210.2021.1.224962Keywords:
tubular breast, congenital breast abnormalities, breast surgery, breast reconstructionAbstract
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
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)