In some women normal breast development is impaired resulting in breasts that are abnormally shaped or asymmetric. The abnormality may also affect the chest muscle and upper limb. These congenital breast deformities include tuberous breast, Poland syndrome and breast asymmetry. Breast size, shape, symmetry are often central to a woman’s femininity and self-confidence and correction of a breast deformity can have a profound positive impact on psychosocial wellbeing and sexuality.
Mr Karri is able to correct your breast deformity using a variety of techniques including enlargement with implants or fat, breast lift, breast reduction and areola reduction.
Tuberous breast deformity
Tuberous breast deformity, also known as tubular breasts, is a congenital breast deformity characterised by breast asymmetry, constriction of the breast base, enlarged areola, areola herniation (puffiness of nipple-areolar complex), hypoplasia (small breast), ptosis (drooping breast), breast skin deficiency and high inframammary fold. There is a spectrum of severity and not all features may be present. Milder forms of tuberous breast deformity are often under-diagnosed.
The surgical correction of tuberous breast deformity is highly specialized and may be performed as a one-stage or two-stage procedure, depending on the severity.
In the majority of cases, Mr Karri performs one-stage reconstruction incorporating correction of the areola herniation, correction of the hypoplasia and release of the lower-pole breast constriction.
In very severe cases, where there is insufficient breast skin envelope, a two-stage procedure may be required in which a temporary tissue expander is used to expand the skin and breast tissue initially. Once the correct breast size has been reached the tissue expander is replaced with a corresponding-volume breast implant.
In treating tuberous breast deformity, Mr Karri advocates dual-plane augmentation for correcting the hypoplasia. This approach ensures ample soft-tissue coverage of the upper pole of the implant by muscle, expansion of the deficient lower pole breast gland and reduced risk of capsular contracture (see capsular contracture).
As tuberous breast deformity presents with varying degrees of severity, the surgical plan must be highly personalized. During your consultation with Mr Karri, he will carefully discuss the most appropriate surgical plan to correct your tuberous breast deformity, taking into account your specific breast anatomy and desires.
Poland Syndrome, also known as Poland’s Syndrome or Poland Sequence, is a congenital deformity of the chest and upper limb on one side. The severity can vary from characteristic unilateral absence of the chest muscles to complete absence of the breast.
The surgical correction of Poland Syndrome also requires a customized approach. Mild breast hypoplasia may be corrected with a breast implant whereas complete absence of the breast may be corrected with tissue expansion and replacement with an implant or serial fat grafting.
During your consultation, Mr Karri will undertake a detailed discussion and explain all your options to achieve the ideal outcome.
Breast asymmetry is more common than one would think and indeed, it is unusual for a pair of breasts to be completely symmetrical. However, when the degree of asymmetry is significant, the deformity may be corrected with augmentation, mastopexy or reduction.
For some women surgery may be necessary on both breasts to achieve symmetry. Furthermore, if augmentation is necessary some women may prefer natural augmentation with fat grafting rather than with an implant.
In many cases breast asymmetry is a reflection of asymmetry of the bony ribcage. Although the breast asymmetry can be improved, the asymmetric ribcage will remain unchanged.
As with all surgical procedures, breast deformity correction has risks that should be considered before a decision on treatment is made. Risks include;
Scar / poor scarring.
Infection – very rarely an infection can arise which may require treatment with antibiotics or further surgery.
Haematoma – excessive bleeding into the breast can occur (known as a haematoma) and may require drainage. It is important that you you do not take any products containing aspirin, anti-inflammatories, blood thinners or vitamin E for 14 days prior to your operation as these medications can greatly increase the risk of bleeding.
Nipple-areola necrosis – rarely, the blood supply to the nipple or areola is interrupted leading to partial or total loss of the nipple or areola.
Changes in nipple or breast sensation – while sensation typically returns within several weeks, some loss of feeling may be permanent.
Asymmetry – minor degrees of postoperative asymmetry are common. Nearly all women have some asymmetry between their breasts before surgery, and in some women this asymmetry is actually due to differences in the underlying muscles and ribs.
Implant malposition – if a breast enlargement has been performed, the implant may not remain in the correct position after surgery. The implant may sit up too high, off to the side, or too low. The breast implant needs to sit properly behind the breast itself. It is important to remember that breasts come in many different sizes and shapes.
Difficulty breast-feeding – some women might have difficulty producing enough milk for breast feeding after breast deformity correction.
Need for revision surgery in the future.
Risks of general anaesthesia, such as feeling sick and vomiting, deep vein thrombosis, shivering and sore throat.