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Tuberous Breast Deformity

Classification and Treatment Strategy for Improving Consistency in Aesthetic Correction

Kolker, Adam R. M.D.; Collins, Meredith S. M.D.

Plastic and Reconstructive Surgery: January 2015 - Volume 135 - Issue 1 - p 73–86
doi: 10.1097/PRS.0000000000000823
Cosmetic: Original Articles
Cover Article

Background: Tuberous breast deformity is a common congenital anomaly with varying degrees of constriction, hypoplasia, skin deficiency, areolar herniation, and asymmetry that poses challenges to consistency in aesthetic correction. In this study, the authors classify tuberous breast deformities, and evaluate their techniques used for treatment.

Methods: Twenty-six patients (51 breasts) treated from 2008 to 2012 were included. Mean patient age was 25 years (range, 18 to 39 years). Cases were classified using a three-tier system. A periareolar approach and glandular scoring maneuvers were used in all cases. Prosthetic placement (implant or tissue expander) was subpectoral (dual-plane) in all cases. The selection of one- versus two-stage correction and mastopexy techniques is presented with reference to the specific deformities in each tier.

Results: Mean follow-up was 22 months (range, 8 to 37 months). Twelve type I, 26 type II, and 13 type III deformities were treated. Periareolar incisions only were used in two (4 percent). Circumareolar mastopexy was used in 49 (96 percent), and vertical mastopexy was used in four (8 percent). One-stage correction was achieved in 47 (92 percent); four (8 percent) were treated in two stages with tissue expansion. The global complication rate for all patients in this study is 7.8 percent—two breasts (3.9 percent) had capsular contracture, and two (3.9 percent) had postoperative malposition.

Conclusion: The authors’ experience demonstrates that satisfactory results can be obtained with appropriate classification and treatment of tuberous breast deformity with periareolar access, glandular scoring, subpectoral implant placement, and mastopexy techniques tailored to the specific deformity type.


New York, N.Y.

From the Department of Surgery, Division of Plastic Surgery, Icahn School of Medicine at Mount Sinai.

Received for publication November 25, 2013; accepted April 23, 2014.

Presented at the 30th Annual Meeting of the Northeastern Society of Plastic Surgeons, in Washington, D.C., September 20 through 22, 2013.

Disclosure: The authors have no commercial associations or financial interest to declare in relation to the content of this article. No external funding supported this study.

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Adam R. Kolker, M.D., 710 Park Avenue, New York, N.Y. 10021,

©2015American Society of Plastic Surgeons