Case-31557 Gallery

Before and after bilateral tubular breast correction with mastopexy and augmentation in a 27-year-old woman. Her breasts had an extreme tubular deformity, with a constricted breast base, high inframammary folds, and most of the breast tissue lying immediately behind the areola. She said she felt “like a man” and just wanted her breasts “to look normal” – which is a common expression of patients with tubular breast deformity.

She also had an indented sternum, known as “pectus excavatum” (caved-in chest). This is a common chest wall difference that does not need correction in most cases – however, for this patient, she had surgery at five years of age as the sternum was compressing her heart and lungs. Note the chevron-shaped scar at the top of her chest from her childhood surgery. It is possible that her breast bud was injured during this surgery, which may have accentuated her breast deformity.

Pectus excavatum creates an inward central slope to the breasts. Therefore, proper placement of breast implants is required to avoid having them fall toward one another in the midline – a condition known as “symmastia”.

For this patient’s surgery, smooth round silicone gel breast implants were placed on top of the muscle, in the subglandular position. A periareolar mastopexy helped to reduce the protrusion of her areolas and decrease their diameter. Implants are not inserted through the periareolar incision, as bacteria reside in this area and we do everything possible to avoid introduction of bacteria around the implant – as this is a known cause of capsular contracture.

Follow up photos are shown 1 year after surgery. She is thrilled with her results and is excited to try on wedding dresses with a plunging neckline, as she has just become engaged to be married!