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

  1. 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
  2. Galich, S. P., & Pinchuk, V. D. (2009). Esteticheskaya khirurgiya grudi. Rukovodstvo dlya vrachei [Aesthetic Breast Surgery. A Guide for Physicians]. Kyiv. [in Russian].
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. Nahabedian, M. & Neligan, P. (Eds.). (2018). Plastic surgery. Volume 5: Breast (4th ed.). Elsevier.
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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.
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
  26. 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
  27. 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
  28. 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].
  29. 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
  30. 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
  31. 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
  32. 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
  33. 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

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 2026May16];23(1):146-51. Available from: https://zmj.zsmu.edu.ua/article/view/224962

Issue

Vol. 23 No. 1 (2021)

Section

Review

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.  Лицензия Creative Commons