Congenital Breast Deformity Correction
Surgery is sometimes done to correct congenital breast deformities such as breasts that are very different in size (asymmetry or balancing), tuberous breast deformity, or extra or supernumerary breast tissue that is found away from the natural breast location.
“Hypoplastic breast” means that one or both breasts did not develop normally and fully during puberty. This can result in significant breast asymmetry if just one breast is involved or very small breasts in proportion to the woman if both are involved.
Most of the time, we don’t know what causes this condition, although sometimes it can be due to tuberous breast deformity or conditions such as Turner’s or Poland Syndrome. Turner’s Syndrome is a rare chromosomal abnormality (affecting only 1/2500 girls) which is caused by a missing X chromosome, and results in many physical changes such as short stature and undeveloped breasts. Poland Syndrome is a congenital syndrome that develops in the first 6 weeks after conception. The exact cause is unknown but it usually only involves one side of the chest. The spectrum of Poland syndrome features can vary considerably and may include underdeveloped breasts, underdeveloped chest muscle (pectoralis muscle), rib abnormalities, absence of armpit hair, and congenital hand abnormalities such as short or webbed fingers.
Hypoplastic Breast Treatment
Surgical treatment for hypoplastic breast may involve the use of tissue expanders to stretch-out a skin deficiency or surgery to place implants or the patient’s own tissue under the breast to add volume. In cases of single-sided hypoplastic breast, another option is to reduce the other more developed breast.
Tuberous Breast Deformity
Tuberous breast deformity (or constricted breast) is a congenital abnormality that results in failure of one or both breasts to develop fully during puberty.
The exact cause is unknown. There is a wide range of severity in tuberous breast deformities. In mild cases, the breast may just be slightly smaller. However, in severe tuberous breasts, the base of the breast might appear constricted with less skin and volume along the crease, the crease may be positioned too high on the chest, or there may be significant bulging (herniation) of breast tissue through the areola.
Tuberous Breast Treatment
Treatment depends on the severity, but the principles of treatment include:
- Expanding the constricted breast base
- Lowering the breast crease
- Adding volume and skin
- Reducing the breast tissue that is bulging through the nipple-areolar complex (NAC) and reducing the NAC size
This may involve the use of tissue expanders to stretch out the skin or the use of implants or tissue from elsewhere on the body to add volume.
Supernumerary Breast Tissue
Some people may be born with extra breast tissue outside of the natural breast location on their chest. This extra tissue, based on the way embryos develop, can be found anywhere from the abdomen to the armpits. Most commonly it is found in the armpits, known as the “axillary tail of Spence.” The amount of breast tissue can also vary considerably from a small extra nipple, to a large volume of extra breast tissue.
Supernumerary Breast Treatment
In most cases, no treatment is required. If, however, the extra breast tissue causes physical, mechanical, or psychological discomfort, the patient may have surgery to remove the extra tissue.