THE TUBEROUS BREAST DEFORMITY - CLASSIFICATION AND TREATMENT

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.