Aesthetic correction of the tuberous breast demands that all elements of the deformity are addressed, including the skin, the breast tissue, and the nipple-areolar complex. It is important that the presence of the tuberous deformity is recognized by your surgeon prior to surgery, as inadequate correction of any of these elements typically results in a worsening of the appearance of the breast.
If the skin on the lower pole of the breast is tight or deficient, a tissue expander, which is a temporary implant, may be placed to stretch out the tissues prior to definitive implant placement. If the breast tissue itself is deficient in volume, an implant can be very helpful as it not only adds volume, but also provides an aesthetic, round shape to the base of the breast. The size of the nipple-areolar complex frequently requires reduction, and any breast tissue which has herniated through this region must be reduced and returned to the lower pole of the breast.
Patients frequently request that the tuberous breast be corrected without the use of implants. This is possible if there is an adequate volume of breast tissue which requires only release at the lower aspect of the breast. In these cases, a breast lift alone may suffice. In most cases, however, an implant is requires to provide a rounded shape to the lower portion of the breast. Fat grafting to the breast is another option if patients wish to avoid an implant. While this is a good option for some patients, it does require that the patient have enough of her own bodily fat to provide for the grafting procedure. In addition, most patients require at least two procedures for fat grafting, as 30-50% of the grafted fat is typically absorbed by the body. The optimal technique for a given patient is determined by both her physical examination and her goals.