Management of Tuberous Breast Deformities: Review of Long-term Outcomes and Patient Satisfaction with BREAST-Q.
Tenna S, Cagli B, Brunetti B, Barone M, Persichetti P.
Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy.
The treatment of a tuberous breast deformity has changed over the years, with a large variety of procedures described. However, maintaining a long-lasting breast contour is an ongoing challenge. The aim of this study was to evaluate the long-term results of tuberous breast corrections, focusing on the incidence of secondary procedures and patient satisfaction.
MATERIALS AND METHODS:
Forty-six patients who underwent correction of a tuberous breast deformity from 2000 through 2013 were considered. Age, degree of deformity, asymmetry, BMI, pregnancy, first surgical technique used, complications and further surgical procedures were evaluated. Statistical analysis was conducted to identify predicting factors for multiple procedures. Patient satisfaction was evaluated with BREAST-Q.
Eighty-eight breasts were treated: 57 breasts underwent implant-based corrections, whereas 31 breasts underwent autologous procedures. A multi-step procedure was initially planned in 7 breasts only, and 41 breasts underwent secondary procedures: 33 out of 53 breasts (62.3%) were re-operated in the implant-based group, whereas 8 out of 28 breasts (28.6%) were re-operated in the autologous group. Statistical analysis showed a correlation between the number of procedures and young age (P = 0.0253) and between the number of procedures and the primary surgical technique (P = 0.0132). The BREAST-Q evaluation suggested that patient satisfaction was comparable.
The question of time is one of the main issues in breast surgery. The management of tuberous breast deformities requires a customized strategy considering all parameters to improve the longevity of the result in the long term.
Fig 1 Treatment algorithm according to the degree of deformity, BMI, age, asymmetry and patient expectations
Fig. 2 a, b C.G., 18 years old,deformity type 3, grade A. c, d Results 4 years after a onestep implant-
based correction with a submuscular PEI (290 cc right and 310 cc on the left)