Correction of congenital breast deformities

Tubular breast deformity is a malformation of the female breast of varying severity. These can be roughly divided into three types. Type I shows malformation of the lower inner quadrant, Type II shows malformation of the lower half of the breast, and in Type III all four quadrants are underdeveloped. All types have in common the fact that the base of the chest is too small and the lower breast crease is misplaced upwards. In addition, an incidence of glandular tissue may occur in the areola. Overall, these breasts, due to their tubular growth, are perceived as abnormal and unattractive. It is not surprising that the affected patients are extremely perturbed by this situation.

There are also numerous expectations that affected patients have for correcting this maldevelopment. Of course, the desire is for an aesthetic improvement in the appearance of the breasts. However, the expectations for the size of the breasts are often different. One patient may be satisfied with the existing breast size, while another may desire a significant volume addition, while others may desire a reduction.

Poland syndrome is a defect of the female breast which is associated with underdevelopment of the large pectoral muscle (pectoralis major). Incorrect development of the arm and hand can alsoa occur on the affected side. The affected patients thus lack the entire mammary gland, as well as the underlying muscle. This can not be masked by a prostheses inserted into the bra because of the lack of anterior axillary line.

When correcting this development, not only the affected side plays a role, but also the normal opposite also. A hyperplastic, very large and possibly hanging chest can not be reconstructed. In these cases, it may also be necessary to consider also correcting the unaffected breast.

Generally there is a lack of volume. This can be approached using various surgical methods. If only a small amount of volume is desired, a one-step approach can lead to the goal. An anatomical breast implant is inserted. However, if more volume is needed, a breast expander must be introduced in an initial operation. The skin coating is stretched and prepared for the final implant size. Another possibility is the correction with autologous tissue. In the process, tissue with preserved blood flow (latissimus flap muscle) is inserted into the breast from the back. One advantage of this is that the anterior axillary line as well as the function of the large pectoral muscle (musculus pectoralis major) can be reconstructed. A breast implant is often still needed in this procedure.

In the case of funnel chest, the sternum bulges inwards and there is a cavity between the breasts. The formation can of course vary in quality. In childhood and adolescence, this deformation can be corrected by a minimally invasive thoracic surgery.In adulthood, this is no longer possible, and only with surgery of the sternum and ribs will the situation be remedied.However, in most cases, there is no functional impairment, so that the main impact is purely aesthetic. Aesthetic improvements can be achieved very well using less invasive procedures.

Mild cases can be aesthetically corrected to an excellent level by one or more autologous fat transplants. In severe cases, custom-made implants are possible. In this case, an impression of the cavity is made as a first step and then a silicone implant is individually made. This is achieved per an incision in the lower breast fold and the introduction of the appropriate breast implant. If desired, this procedure can also be combined with breast enlargement.

Asymmetry of the breasts is often perceived as psychologically very stressful. The possible combinations of the asymmetry of the breasts in relation to size, shape, position of the nipples, etc. is almost endless. The expectations of our patients to correct their breast asymmetry also vary. In addition to the desired improvement in terms of shape, the expectation of the breast size is often very different.

Inverted nipples are characterised by the nipple retracting into the breast. In addition to the aesthetic disfigurement, there are also hygiene problems related to this. When correcting the nipples, the fibers which pull the nipples inward are severed. Internal seams with dissolving stitches prevent retraction and achieve lasting results. This is generally an outpatient procedure. Often, a correction of the inversions is performed in addition to another breast surgery.