I often encounter patients who are concerned about the shape and appearance of their breasts, particularly those with tuberous or tubular breasts. This condition, while not widely discussed, is relatively common and can significantly impact a person’s self-esteem and body image.

What Are Tuberous, or Tubular Breasts?

First described in 1976, tuberous breasts, also called tubular breasts, result from a developmental abnormality that becomes evident during puberty. The breast tissue doesn’t develop normally, leading to various aesthetic concerns.

Characteristics of Tuberous Breasts Include:

• A narrow base of the breast
• Herniation or puffiness of the areola
• Asymmetry between the breasts
• High inframammary folds
• Limited breast tissue, resulting in smaller, sometimes sagging breasts

What Causes Tubular Breasts?

The exact cause of tubular breasts is not fully understood but is believed to be a congenital issue linked to genetics. It’s not something caused by lifestyle or environmental factors, and is still a subject of ongoing research and discussion. Most experts agree that this condition starts developing during the early stages of breast formation before birth. Several theories try to explain why tuberous breasts occur:

1. Tissue Development Issues: There might be a problem in how breast tissues differentiate and develop in the fetal stage. There’s also some evidence suggesting a genetic link. Studies involving twins and family members with the condition hint that genetics might play a role in its development.
2. Problems with the Areolar Fascia: This theory suggests that there could be a lack of support in the skin around the nipple or a tight ring of fibrous tissue that restricts the normal growth of the breast, causing it to take on a tubular shape.
3. Hormonal Influences: Another possibility is that hormones, which are crucial for breast development during puberty, don’t work as they should. This could prevent the breast from growing outward and downward normally, leading to a more protruded and narrow shape.

In studies looking at the microscopic structure of breast tissue from patients with tuberous breasts, researchers have noticed unusual patterns in the collagen fibers, which are part of the supportive structure of the breasts. However, these findings haven’t led to a conclusive understanding of the condition.

Despite these theories and observations, there’s still no clear agreement in the medical community about the exact causes of tuberous breasts. Most of the research has focused more on surgical treatments than the underlying reasons for the condition. More in-depth studies are needed for a better understanding of tuberous breasts.

Tubular Breast Grading

Tuberous breasts present in various types, each with distinct characteristics. In 2018, Innocenti and his colleagues proposed a new classification for tubular breasts, including more minor forms:

Hypoplastic

• Soft: This is the most severe form, where the skin covering the breast is extremely thin and can be easily pinched into folds.
• Solid: Characterized by a wider base of the mammary gland, a smaller areola, and thicker skin coverage. The lower part of the breast appears flat or concave, and the inframammary fold is often absent.

Normoplastic

• Type I–II: These types show a deficit in breast volume, particularly in the lower pole. Type I affects only the medial quadrant, while Type II involves both medial and lateral quadrants. Features include fullness in the upper pole, a deficiency of skin cover in the lower pole, varying degrees of sagging (ptosis), a shorter distance between the inframammary fold and the nipple-areola complex (NAC), and a downward-pointing NAC.
• Type III: This type is marked by a permanent or intermittent protrusion of the glandular tissue inside the areola.

Each type of tuberous breast has specific physical features and variations, which are important for determining the most effective treatment approach.

Men With Tuberous Breasts and Gynecomastia

In patients with gynecomastia, a condition characterized by the enlargement of breast tissue in males, the occurrence of tuberous breasts can present unique challenges. Tuberous breasts in gynecomastia are marked by the same developmental abnormalities as in females, such as constricted breast base, herniated areola, and asymmetrical breast development. This can lead to a more pronounced and tubular appearance of the male breast, often causing significant psychological distress due to the deviation from typical male chest contour. The presence of tuberous breasts in gynecomastia patients requires a tailored approach to treatment, often involving a combination of techniques to correct the tubular deformity and reduce the excess breast tissue, ensuring a more typical male chest appearance. This condition underscores the complexity and individualized nature of gynecomastia and its treatments, highlighting the need for a thorough evaluation and a personalized treatment plan from a skilled plastic surgeon.

Tuberous Breast Treatment Options

It’s important to acknowledge the emotional aspect of this condition. Many individuals with tubular breasts experience a significant impact on their self-confidence and body image. Addressing this condition is a physical correction and a step towards emotional well-being. Thankfully, there are effective treatments.

As a plastic surgeon, I tailor the treatment to each patient’s unique needs. The goal is to create a more traditional breast shape and achieve symmetry.

• • Breast Augmentation: This involves using implants or fat grafting to add volume and improve the shape of the breasts.
  • Breast Lift: We can lift and reshape the breast tissue to improve the overall appearance.
  • Areola Correction: This technique reduces the areola size if it is enlarged or protruding. New advances in reconstructive surgery describe a petal pattern methodology for treating tuberous breasts with domed nipples.
  • Tissue Expanders: In more severe cases, we might use tissue expanders to gradually stretch the skin and breast tissue, preparing it for further reconstructive procedures.
  • Gynecomastia Treatment: Our goal is to accentuate your chest’s natural, masculine to help you feel more confident and comfortable. We can also address tuberous deformity of the nipple-areolar complex (NAC), which can accompany gynecomastia.

Frequently Asked Questions About Tuberous Breasts

Is the condition hereditary?

While the exact cause is unknown, some evidence suggests a genetic link.

Will insurance cover the surgery?

Coverage varies. Some insurance plans might offer partial coverage in cases with a significant physical or psychological impact. It’s best to check with your provider.

Are the results of the surgery permanent?

The results are long-lasting, but factors like aging, weight fluctuations, and pregnancy can affect the outcome.

What are the risks associated with surgery?

As with any surgery, risks include infection, scarring, and anesthesia-related issues. I ensure my patients are well-informed about all potential risks before proceeding.

Tubular breasts, though a source of discomfort for many, can be effectively treated with modern surgical techniques. My goal as a plastic surgeon is to enhance my patients’ physical appearance and uplift their emotional well-being. If you’re considering treatment for tubular breasts, I encourage you to schedule a consultation with us in Arizona to explore your options.

Book a Plastic Surgery Consultation in Arizona

Our qualified board-certified plastic surgeons at Plastic Surgeons of Northern Arizona would love to meet you to discuss your goals and treatment options. Book a consultation in Flagstaff, Sedona, Cottonwood, Prescott Valley, or Kingman today.