Treatment of Tuberous or Constricted Breasts*

Tuberous or constricted breasts are far more common than many woman think. The condition is defined by a high inframammary fold, large areolas compared to the size of the breast, possible herniation of the breast tissue through the areola, and widely spaced breast tissue. The term tuberous has been used to describe this condition because at its worst, it can resemble the irregular shape of tubers such as the common potato. Constricted breasts may share some of the same characteristics, but not all the criteria are met to be called a tuberous breast. In the past, a two stage reconstruction was advocated with the first stage being tissue expansion with a breast expander that needs to be inflated at regular intervals until the breast reaches a desired shape, then the expander is swapped out for a permanent implant. This was a slow tedious process, that required at least two surgeries, and multiple visits to the plastic surgeon's office to inflate the expander. Today the approach we take at VIP Plastic Surgery is a one stage approach. We employ anatomically based and 3D rendered simulations to determine the appropriate size for each patient's goal. Intraoperatively, we employ a number of techniques including a dual plane approach and radial scoring of the tissue to allow for maximal expansion while still protecting the implant with muscle. In all our one stage correction of tuberous and constricted breasts has proven to be safe and effective.