To date there are many descriptive terms for the tuberous breast defor
mity but there is no widely accepted nomenclature. A retrospective stu
dy was undertaken of 68 tuberous breasts and the operative corrections
performed. The deformities were classified into four types. Type I (h
ypoplasia of the lower medial quadrant), type II (hypoplasia of the lo
wer medial and lateral quadrants, sufficient skin in the subareolar re
gion), type III (hypoplasia of the lower medial and lateral quadrants,
deficiency of skin in the subareolar region) and type IV (severe brea
st constriction, minimal breast base). Areolar prolapse, usually regar
ded as a major symptom, was only found in 30 (44%) deformed breasts. P
ostoperative review of 51 breasts in 31 patients showed that type I ca
ses treated by reduction mammaplasty of adequately sized breasts or au
gmentation of hypoplastic breasts had excellent results. These procedu
res with additional spreading of the breast tissue in type II deformit
ies give good results. Severe cases (types III and IV) treated by augm
entation and tissue spreading procedures have an unsatisfactory shape
and have a 'second crease' deformity. For types III and IV, additional
skin in the subareolar region by tissue expansion or flap procedures
is necessary. There is no one method to correct 'the' tuberous breast
but there are many procedures which should be used according to the ty
pe of deformity. The classification developed could end the confusion
in nomenclature.