Background:Tubular breasts are caused by connective tissue malformation and occur in puberty. The main clinical characteristics of the tubular breast are breast asymmetry, dense fibrous ring around the areola, hernia bulging of the areola, megaareola, and hypoplasia of quadrants of the breast. Pathology causes great psychological discomfort to patients.Methods:This study included 17 patients, aged 18 to 34 years, with tubular breast type II who had bilateral pathology and were treated from 2013 to 2016. They had surgical treatment by method of the clinic. Correction technique consisted of mobilization of the central part of the gland and formation of a glandular flap with vertical and horizontal scorings, which looks like a “chessboard,” that was sufficient to cover the lower pole of the implant. The flap was fixed to the submammary folds with stitches that prevented its reduction and accented a new submammary fold. To underscore the importance of the method and to study the structural features of the vascular bed of tubular breast tissue, a morphological study was conducted.Results:Mean follow-up time was 25 months (range between 13 and 37 mo). The proposed technique achieved good results. Complications (hematoma, circumareolar scarring, and “double-bubble” deformity) were identified in 4 patients.Conclusions:Our morphological study confirmed that tubular breast tissue has increased vascularity due to the vessels with characteristic minor malformation and due to the high restorative potential of the vascular bed. Therefore, an extended glandular flap could be freely mobilized without damaging its blood supply; thus, the flap in most cases covered the implant completely and good aesthetic results were achieved.

First experience of application of a perforant flap of a deep femoral artery - a РАР-flap

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.