Abnormal Shaped Breasts

Abnormal Shaped Breasts

There are a variety of different breast anomalies which result in abnormal shaped breasts. These anomalies only present themselves once the breast starts to grow – at about the age of 10-12 years old. It usually takes about two years from the start of breast development to the end of breast development. After this time, if the breast is abnormally shaped, it will not improve with age. The only caveat to this are that there may be some additional breast growth with hormonal changes (eg commencing the oral contraceptive pill; or pregnancy) or weight gain.

The common causes of abnormally shaped breasts are:

Tuberous Breast. It is thought that the underlying cause of this condition is an unusually tight deep layer of tissue which restricts breast growth – especially in the lower half of the breast. This deep tight deep layer is not present at the areola and so the growing breast tissue ‘herniates’ out through the weaker areola.

A typical tuberous breast showing a lack of breast tissue, narrow breast width and height, and dilated ‘herniated’ nipple/areolae

Many girls notice that when they are cold (and the areola ‘tightens’) they get a better breast shape.

This patient’s breasts look relatively normal when she is cold and has areolar contraction, but when she warms up her areolae dilate and the features of tubular breast become more evident

Treatment options are designed to increase the breast volume, widen the breast ‘footprint’ and tighten the areola.

Treatment of tuberous breasts is difficult and needs to be tailored to suit the individual patient. It is unlikely that the results of surgery will be as good as those seen following augmentation of normal breasts. The tight constriction in the crease under a tuberous breast is notoriously difficult to eradicate and may result in a ‘double bubble’ deformity.

Tuberous breasts corrected with simple breast augmentation
Tuberous breasts corrected with circumareolar mastopexy and breast augmentation

Tubular Breast. This is very similar to a tuberous breast and is thought to share the same underlying cause. In tubular breasts there tends to be more breast growth and as the breasts enlarge, they form a long tube-like breast shape.

Tubular breast corrected with circumareolar mastopexy and breast augmentation

Poland Syndrome. This is a condition which can affect the shape of the breast as well as causing abnormalities in the shape of the chest wall and arm/hand on the affected side. Typically, girls with Poland Syndrome will have one small breast (or even absent breast) and no pectoralis muscle on the affected side.

A patient with a left sided Poland syndrome. Note small left breast and the high crease in her left armpit due to the missing pectoralis major muscle

Treatment is difficult and the results of surgery are not as good as those seen following augmentation of normal breasts.

If you have Poland Syndrome you should discuss all possible treatment options with your plastic surgeon and come up with a tailored plan for corrective surgery and have a clear idea of what can be realistically achieved.

Treatment options include fat grafting, breast implant surgery, flap reconstruction, matching surgery to the opposite breast. More aggressive surgical options include muscle transfers to disguise the absent pectoralis major muscle at the front of the armpit.

Poland syndrome corrected with fat grafting to left breast and armpit, and matching reduction of right breast