Tuberous breast deformity (TBD) is a medical condition that occurs when one or both breasts fail to develop during puberty, leading to breasts that are tubular in shape instead of round. Though tuberous breasts are not a health concern, they can have a serious impact on emotional well-being.

How is the condition diagnosed?

Research has shown that there is a measurable impact on self-esteem caused by tuberous breasts, which can even result is severe psychological distress. Tuberous breasts can also cause difficulties during breastfeeding, as they do not have enough glandular tissue to produce milk.

Diagnosing tuberous breasts is done through a visual examination. There are several key characteristics to TBD, including:

• A lack of breast tissue
• Breast tissue that can be described as oval, elongated, pointed, or cylindrical
• A narrow breast base
• Drooping or sagging breasts
• Herniation of the areola (an enlarged areola)
• Breast asymmetry
• Breasts with a gap of more than 1.5 inches between them
• Large nipples that point either upwards or downwards

What causes tuberous breasts?

While several studies have examined the surgical options available to correct tuberous breasts, little research has been done into the actual causes of this condition.

There is no known genetic cause, but one hypothesis is that tuberous breasts develop in the womb. A 2011 study published in The Canadian Journal of Plastic Surgery suggests that excess collagen in the fascia corporis affects gland development, and by extension the shape of breasts.

The most widely held cause of TBD is irregular connective tissue at the base of the breast. This tissue constricts the base of the breast, preventing it from properly developing.

Can tuberous breasts be fixed?

The good news is that the condition can be fixed through a procedure known as tubular breast augmentation.

The approach to TBD correction depends on the severity of your condition and the particular characteristics of your breasts. For example, some patients may only require breast implants, while others may need both implants and a mastopexy (breast lift).

Tuberous breast correction is similar to standard breast augmentation surgery. A saline or silicone implant is used to compensate for a lack of natural volume.

However, tuberous breasts cannot be corrected through traditional breast augmentation alone. If traditional breast augmentation is performed on a tuberous breast, the areola can become overly prominent, causing the breast to look even more tubular in shape. As such, tissue expansion must first be performed.

• Tissue expansion

This technique involves expanding the base of the breast and releasing the lower part of the breast where it is typically tight.

The procedure is performed using a tissue expander — a device that resembles a balloon — which is inflated inside the breast to correct its volume.

Ultimately, this technique allows the breasts to fully develop, albeit in a dome shape. That said, breasts do appear much more full and somewhat less tubular.

Traditional breast implants may or may not be necessary following this procedure, depending on the patient’s aesthetic goals.

• Implant insertion (with or without fat grafting)

If breast augmentation is required, a breast implant is inserted to add volume and fullness to the chest. Different sized implants may also be used to fix asymmetry between breasts.

Another option worth considering is fat grafting, a less invasive alternative to traditional augmentation. This procedure involves removing fat from one area of a patient’s body and injecting it into the breasts. Fat grafting can also be performed in addition to implant surgery.

A recent study published in the World Journal of Plastic Surgery found that fat grafting brought high satisfaction rates with minimal complications.

• Mastopexy (breast lift)

In more severe cases of TBD, mastopexy — a breast lift — is another surgical option to correct saggy breasts or protruding areolas. While not necessary in most cases, mastopexy further lifts the breast and reduces the size of areolas.

RELATED: Breast Augmentation, Breast Lift, or Both?

Is tuberous breast surgery covered by insurance?

As correcting TBD is considered to be a cosmetic procedure and does not impact how the breasts function, the procedure is unlikely to be covered by insurance.

That said, many surgeons and those affected by TBD are working to change perception of the procedure as merely cosmetic due to the emotional impact of the condition.

To find out more on tuberous breast correction, contact The Breslow Center in Paramus, New Jersey today.