Tuberous breasts

The causes of this breast malformation are unknown, with genetic factors probably involved.

It seems that abnormalities of the mammary gland, or of its attachments to the skin and pectoralis major muscle in depth, prevent correct expansion of the mammary gland during growth, particularly in the lower part of the breast below the areola.

There are 3 grades of tuberous breasts, with varying degrees of treatment.

• Grade 1: This is the most common form, with only the inferomedial segment absent. The areola looks down and in.
• Grade 2: The entire lower half of the breast is absent. The areola points downwards.
• Grade 3: the upper and lower segments may be absent. In this case, the mammary base is completely narrowed, and the breast takes on a tube-like shape.

Tuberous breasts most often appear during adolescence.

However, Dr. Santini recommends the end of breast growth, to assess the aesthetic impact.

Surgical treatment can then be considered at an early stage, so as not to create complexes or embarrassment in her intimate life.

Breast surgery may be partially reimbursed, subject to the agreement of the CNAM medical officer: the breast deformity must be significant, with a proven psychological impact. As Dr. Santini's practice is not covered by a convention, additional fees may apply.

Two plastic surgery consultations at least 15 days apart are mandatory, during which medical photographs are always taken. These enable us to carry out a 3D simulation to judge the expected result.

Dr. Santini's clinical examination will help determine the best surgical technique, and whether social security coverage is possible: in this case, the agreement of the consulting physician is a prerequisite.

A pre-operative mammogram is systematically prescribed prior to surgery. A support bra should be worn before the operation.

Dr Santini will also tell you about the most important pre-operative precautions:

• Consultation with the anaesthetist at least 48 hours before surgery.
• Stop smoking 1 month before surgery, to reduce the risk of skin necrosis. Stop taking aspirin, anti-inflammatory drugs or oral anticoagulants 15 days prior to surgery, to reduce the risk of bleeding.
• Stop taking oral contraceptives 1 month before surgery, to reduce thrombo-embolic risk.
• Pregnancy should be avoided for at least 2 years after the operation, to avoid damaging the aesthetic result.

The aim is to give the breast a natural rounded shape, to lower the submammary fold into the correct position, and to correct the procidence of the areola and reduce its size. General anesthesia is used.

Different techniques are performed depending on the grade, combining breast augmentation, breast reduction and mastopexy techniques:

• GRADE 1: Breast reduction surgery with vertical or T-shaped scar
• GRADES 2 AND 3: Breast prosthesescombined with glandular plasty: the scar is then only located around the areola.

A suction drainage system completes the operation. It is usually placed to reduce the risk of hematoma, and is usually retained for 1 to 3 days, depending on the amount of fluid produced.

The dressing is removed 24 to 48 hours after the procedure. A light dressing will be applied and you will have to wear the non-wired bra prescribed before the operation. It should be worn day and night for 6 to 8 weeks.

The average hospital stay is between 1 and 2 days.

The threads are absorbable, so no removal is required.

The first shower is permitted the day after the drains are removed.

In the first few weeks after surgery, there is usually some swelling of the breasts. This subsides fairly quickly, although residual swelling may persist for a month or more. Some pain is easily relieved by simple analgesic treatments. Discomfort when raising the arms is very often observed. The period of absence from work is around 10 to 15 days, and from sporting activities around 2 months.

Pregnancy should be avoided for at least 2 years after the operation, to avoid damaging the aesthetic result. Breast-feeding is often possible after surgery, but is neither guaranteed nor recommended.

The final result in terms of breast volume and shape is not visible for 6 months. The breast continues to evolve over the years.

It takes at least 12 months to judge the final appearance of the scars.

Dr. Santini performs several follow-up consultations at approximately 1 month 1 /2, 3 months, 6 months and 1 year after the procedure.

• Social security coverage in certain cases
• A night at the clinic
• 7 to 14 days of professional downtime
• Final result after at least 6 months

Treatment of tuberous breasts, often performed using a combination of techniques, corrects abnormalities in breast development and improves breast shape. Results are visible immediately, but as with all breast surgery, it takes around 6 months to appreciate the final result.

The results are long-lasting and offer a great aesthetic change, improving both breast shape and self-confidence.

What to do before tuberous breast surgery?

• 1 to 2 consultations with your plastic surgeon, including the taking of medical photographs; completion of the CNAM file if necessary
• Handing over and signing of the estimate, respecting the 15-day legal deadline between the first consultation and the tuberous breast surgery.
  Anesthesia consultation, blood test, mammogram as required.
• If prostheses are fitted, choose the most suitable prosthesis with your plastic surgeon.

How does tuberous breast surgery work?

• General anesthesia.
• 2 to 3 hours depending on the technique used
• Overnight hospital stay most often after tuberous breast surgery
• If prostheses are fitted, you will be given a card with the references of the breast implants fitted.

What is the post-operative course of tuberous breast surgery?

• Wear a non-wired bra for 1? months with a breast support band if breast prostheses are used
• Follow-up visit with your plastic surgeon 10 days after the procedure.
• Sutures used in tuberous breast surgery are absorbable.
• Stopping sport after tuberous breast surgery for 1? months.
• 7 to 14 days' leave after tuberous breast surgery
• Final result after 6 months
• Follow-up consultation to monitor breast implants for one year, then every two years