Developmental Breast Asymmetry

Abstract

Developmental breast asymmetry (DBA) can affect psychosocial well-being in the young female. Correction of breast asymmetry may present a reconstructive challenge, especially in tuberous breasts. Fifty-two cases of DBA treated between January 2002 and January 2006 were reviewed. Preoperative clinical assessment of the specific anatomical deformity, subsequent surgical treatment modalities, esthetic outcome, and patient's satisfaction were evaluated. Surgical modalities used in our series include augmentation mammaplasty with or without tissue expansion, parenchymal scoring, nipple areola complex reduction, glanduloplasty techniques, mastopexy and reduction mammaplasty. The mean age of DBA presentation was 21 years; 69% (36/52) patients had tuberous breasts, of which 67% (24/36) were unilateral and 33% (12/36) were bilateral deformities. Patients with tuberous breast deformity presented consistently under the age of 25 years. Esthetic outcome was rated "good" in 75% (39/52), and symmetry rated as "good" in 58% (30/52) by professional evaluation. Surgical treatment is tailored to the affected esthetic units of the individual breast. In our experience, symmetry is the hardest parameter to achieve, particularly in tuberous breasts. Operative treatment is of great value to the psychosocial well-being of the patient. A conceptual approach in the assessment and treatment of DBA is emphasized by this series.

Periareolar Approach for Correction of Bilateral Asymmetric Tuberous Breasts

“…Asymmetry is common finding in tuberous breast deformity and it is very much related to discrepancies as regards; breast volume, shape, areola size, and degree of ptosis. We agree with Bach et al, [32] and Chen et al, [33] that breast symmetry especially breast shape is important and hard task to achieve. I III I I III I II III Right Breast Tuberous breast type III IV II II II II III II Left Breast II III III III I II III III Right Breast II III III II I I III We used periareolar mastopexy approach.…”

Mammary Hypoplasia: Not Every Breast Can Produce Sufficient Milk

“…The majority of the known information regarding women with mammary hypoplasia is in the plastic surgery literature, where it is often called tuberous breast deformity . A history of breast augmentation surgery can confound the diagnosis of mammary hypoplasia because it is often assumed that the breast surgery itself interfered with the anatomy essential for lactation when a woman is unable to successfully breastfeed.…”

“…Nevertheless, this remains the only published study with an attempt to identify women at risk for mammary hypoplasia and contains important information. There are several identified variations of mammary hypoplasia depending on which aspect of the glandular tissue failed to develop . Figure displays some of these variations.…”

Tuberous breast in adolescent: a case report

“…Surgical treatment is different depending on the degree of breast malformation and volume, and should be chosen from a complete clinical examination, because a poor initial clinical analysis can lead to diagnostic errors and inadequate therapeutic indication [15]. There are a wide variety of techniques described in the literature for the treatment of tuberous breast, which include enlargement with tissue expansion or not, reduction of the nipple-areola complex and many other varieties of glanduloplasty techniques [9,[19][20][21][22]. It is very difficult to correct several forms of tuberosal breasts with only one technique or intervention and, most of the time, being necessary the use of multiple interventions, always informing the patient the possibility of several procedures to achieve the best possible final result.…”

“…The early manifestation of signs of this mammary pathology could be observed since before puberty, when hormonal factors stimulate the gland and the mammary growth, due to the anterior projection of the areola-nipple complex and the peripheral expansion of the base of the breasts [3,6]. The breast represents an important symbol of woman's femininity and its deformity result in several psychological problems that, together with the sociocultural influences, motivate surgical interventions to improve its aesthetics [7][8][9]. In this report, it is described the rare case of a 14-year-old woman with tuberous breast and emotional changes as a result from these breast alterations.…”