Also called tubular breasts, snoopy breasts, constricted breasts and conical breasts, a tuberous breast deformity is a congenital breast anomaly affecting breast development. It is not hereditary. Your mom didn’t pass it to you and you can’t pass it to a future daughter. Typical features of a tuberous breast deformity consist of a constricted narrow breast base at the chest wall with pseudoherniation of breast tissue into the areola (pigmented skin around the nipple). This results in a large puffy areola with a tubular looking breast. It is accompanied by underdevelopment of the breasts and a high breast crease. Commonly, there is asymmetry and the breasts are often spaced widely apart. The condition ranges from mild to severe. With mild cases, tuberous breast deformity often goes undiagnosed with many women being unaware of their anatomic abnormality. The ability to breast-feed may be affected with severe cases, as glands and ducts may not be fully developed.
Typically, the tuberous breast deformity becomes apparent after puberty. Girls noticing these changes can have immense psychological problems, affecting self-esteem and inhibition of normal social activity. Often, young women have feelings of inadequacy. Although not life-threatening, this condition can be emotionally devastating.
The good news is that there is definitive treatment for tuberous breast deformity and it involves surgery. Patients with mild deformity often undergo a donut breast lift (circum-areolar mastopexy) with implants. In this procedure, the areolas are reduced, the constriction is released with scoring of the breast tissue, the lower pole is expanded and the breast crease is lowered. Implants are placed to increase size and improve the shape of the breasts. The resulting scar from this procedure is a circular (donut) scar at the border of the areola and is very well concealed. Severe cases may need a 2-stage procedure where a tissue expander is initially placed to expand the skin, followed by exchange to a breast implant along with the other steps. Timing is an important consideration. For young girls, it is preferred to wait until the age of 18 to have the surgery. Anytime after that would also be fine. However, if the psychological impact is great, surgery can be a good strategy for girls as early as 14 or 15. Recovery is relatively quick with minimal pain and downtime. This condition is typically treated by experienced board certified plastic surgeons.