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Advanced Art of Cosmetic Surgery Thomas M. DeWire, Sr., MD, FACS Specializing in Cosmetic Plastic Surgery |
Body Contouring |
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| Breast Augmentation: Special Anatomical Considerations | |
| Tubular or Tuberous Breast Malformation |
| Tubular or Tuberous Malformation of Breast Morphology: | ||
| The ideal breast for augmentation will have a relatively pyramidal shape, with the level of the nipple well above the level of the inframammary fold. Tubular malformation of the breast has many variations, but all share certain common features in various combinations. Tubular breasts tend to have high and tight (narrow arc diameter) folds, abnormally narrow breast tissue base, abnormally broad areola, and central protrusion (herniation) of the breast tissue through the areola, with tendency of the nipples to be very plump. Often the breast tissue cascades forward centrally, falling over the tight fold, and producing significant ptosis and shape distortion. Augmentation alone will result in the appearance of the native breast remaining well-defined atop the new implant mound because of the starting point base diameter | disproportion
to the implant
diameter, and due to the
resistance of the tubular breast
tissue to stretch over an implant,
Augmentation of the breast in patients with tubular
or tuberous
breast malformation
generally requires concomitant
Benelli - type mastopexy to correct the
disproportion of the breast-base to
implant diameters, as well as to retract the protrusive breast
tissue back toward the implant mound. Areola diameter
usually must be reduced, and often the breast
tissue must be radially cut to allow it to flatten over
the implant (like opening an
umbrella), while reducing the
tubular portion of the
skin, to allow for a natural-appearing
augmentation result.
See related page: Benelli Mastopexy |
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| Several variants of tubular breast malformation are seen in the four photos shown at right and below. |
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Two photos of the same patient are shown at left. Note the narrow and high breast bases, oversized areola, and marked ptosis due to the cascading of the tissue over the high folds. |
| Note very high and narrow arc diameter of the breast folds at right , with oversized areolae and short vertical height of the breast bases. Central herniation of the breast tissues is seen n the areolae of this patient. |
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Note the central herniation of the breast tissue into the wide and plump areola with narrow breast base diameter in this variation of the tuberous breast malformation. Benelli lift with augmentation is thus required to create a normal shape. |
| Case 1: A 38 year old with bilateral asymmetrical tubular malformation underwent an augmentation and Benelli lifts to correct the asymmetrical starting point. Note the typical tubular appearance of right breast, but lesser expression of the deformity in the slightly smaller left breast. |  |
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Age: 38 Ht: 5' 10" Wt: 137 lbs Implants: Mentor Type: 375cc Saline Volume: 375cc Size: 36A to 36 C
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| Paired photos were taken pre-op and 3 months post-op |  |
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| Case 2: A 27 year old with asymmetrical tubular breast malformation who underwent breast augmentation with split implant sizes and volumes, along with Benelli mastopexy of the right breast and vertical mastopexy of the larger, and more ptotic left breast. Final symmetry is very good as is the final volume match. |
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Age: 27 Ht: 5' 4" Wt: 190 lbs Implants: Mentor Type: 425cc/375cc Saline Vol: 450cc Right / 375cc Left Size: A to C / D |
| High Nipple and Breast Base Page | Special Considerations Page |
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| Advanced Art of Cosmetic Surgery | ||
| 3974 Springfield Road | ||
| Glen Allen (Richmond), VA 23060 | ||
| 804-290-0200 |
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| ©Copyright 1997-2007 Advanced Art of Cosmetic Surgery: Thomas M. DeWire, Sr, MD, FACS Revised October 29, 2007 04:06:02 PM |
