Tubular or tuberous breast deformity affects some young women during puberty, in one or both breasts. The condition results in underdeveloped cone-shaped breasts with enlarged areolae and the nipple area set wide on the chest. When it occurs only on one side, it leads to breast asymmetry.

Tubular breast deformity is a congenital malformation that only becomes obvious when the breasts begin to develop. It is present at birth but is not inherited.

There appears to be no uniform agreement on the structural cause of tubular breasts. Some experts believe that a constricting ring on the base of the breast prevents its expansion on the horizontal plane. This is what causes the ‘tuberous’ appearance of the breast and forces the breast tissue toward the nipple-areola area. Others believe that herniation of breast tissue can be blamed for the condition. What causes tubular breasts is less important than the emotional discomfort and loss of self-confidence they cause.

Tubular breasts are not merely small. The deformity results in making the breasts narrow at the chest wall, giving them a long tubular shape. The large areolas are set far apart, resulting in an unnaturally wide cleavage.

Tubular breasts are also referred to as constricted breasts, oval breasts, caprine breasts, areolar hernia, hypoplasia (underdevelopment) of the lower pole and tuberous breasts.

The malformation can occur in a single breast or in both breasts.

Reasons for choosing to have tubular breast correction

Asymmetric breasts can be psychologically upsetting and socially limiting. Young women who have tubular breasts usually want to make their breasts appear more rounded and natural looking, so they don’t feel self conscious or embarrassed when wearing clothes or swim wear. Correction of tubular breasts can help improve self-confidence and body image.

What to expect

The most common treatments to correct tubular breasts are breast implants or tissue expansion. You can read more about breast implants in the article on Breast Augmentation (augmentation mammoplasty) found in the procedures section of this website. The article on Tissue Expanders for Breast Reconstruction can help you understand how tissue expanders work.

But correction of tubular or tuberous breasts is not merely a matter of inserting a breast implant, as in the case of breast augmentation surgeries. Before breast implants are put in place, the surgeon has to structurally change the breast tissue that keeps it from naturally expanding.

If only one breast is affected, the surgery can be done with or without surgery on the unaffected breast.

There are a number of surgical techniques used to treat tubular breasts. One technique requires making an incision along the bottom edge of the areola. Through this incision the surgeon reaches to the base of the breast to make a series of incisions inside that widen the base of the breast. This brings the inner edges of the breasts closer to create more natural looking cleavage.

Correcting the tubularity is done by removing some tissue from the under surface of the breast. Removal of tissue in this way transforms the previously tubular, conical shaped breast into a normal looking breast that has even thickness all around. In effect, a narrow-base cone shape becomes a globe with a much wider base.

The next step is inserting the breast implant. Breast implants can be placed over or under the chest muscles. You will need to discuss your options with your surgeon before surgery and make a choice from the wide variety of implant shapes and sizes available. This technique produces good aesthetic results and has been shown to result in high patient satisfaction rates.

Another technique uses the breast tissue from the constricting ring to provide volume to the breast. This method can be used with or without breast implants. The oversized nipple areola complex can be made smaller using a donut-shaped piece of skin from around the nipple.

In both these techniques all scars are confined to the margin of the areola, making them virtually invisible. The techniques do not disturb the lactiferous ducts of the breast and help preserve normal breast function.

There are other techniques used to correct tubular breasts. The specific technique used in your case will depend on the surgeon as well as on your needs.

Before and after surgery

There are several things you can do to prepare for any surgery and these apply to surgery performed for the correction of tubular breasts as well.

There are general steps that can speed up the healing process after surgery. Follow these and your surgeon’s instructions carefully to ensure speedy healing and a good outcome.

A set of postoperative instructions will be given to help reduce the risk of complications during the recovery period. Make sure to follow those instructions to the word. If there are any doubts, clarify the matter with your surgeon and/or practice staff.

Possible risks and complications

As with any surgical procedure there are risks involved in each type of surgery for correcting tubular breasts. You should be fully aware of potential risks and complications involved in any surgical procedure before you elect to go through with it.

Complications that may occur during or after corrective breast surgery and breast augmentation include:

• Bruising and swelling are to be expected in any type of breast surgery.
• Hematomas, or localised swellings that are filled with blood, may occur.
• Skin necrosis or skin death occurs in some cases.
• Loss of nipple sensation may occur when incisions are made close to the nipple and areola.
• Capsular contracture can occur when excessive scar tissue forms around the breast implant. It can tighten around the implant, making it change shape, become firm and cause a lot of pain as a result.
• Breast asymmetry.

Just as you would discuss potential benefits before surgery, it is always advisable to ask your surgeon to address the potential risks as they apply to you. Discuss with your surgeon the risks and complications you may face as a result of the specific technique that will be used. Your surgeon can also advise you on how to avoid or minimise some types of risk.

Rough costs involved

The cost of correcting tubular breasts will vary depending on the surgeon you choose, fees for the anaesthetist and the facilities used. The exact procedure that must be performed as well as whether the correction is necessary on one breast or both have to be considered in the total cost. Cost of implants will also have to be factored in.

Your surgeon will help you estimate potential costs after an initial consultation.

Depending on the extent of tubularity, you may receive Medicare rebates on some of the costs involved. Operations to correct milder forms are not eligible for these rebates. Some Australian private health insurers may help pay for the hospital bed and theatre fees even if the procedure isn’t covered, depending on your type of insurance cover.

This information is correct as of 2019.