By Consultant Plastic and Reconstructive Surgeon, Elena Prousskaia
Elena not only performs all aspects of general plastic surgery, but has a special interest in breast cancer reconstruction and congenital breast anomalies. In this article, Elena will discuss the nuances of breast asymmetry and a condition called tuberous breasts.
Emotional and physical effects
There is huge public awareness about breast cancer reconstruction, but when I see patients in my clinic, there is very little information on other breast deformities and the transformative effects corrective surgery can have- not only physically but emotionally.
Most of my patients tell me a very similar story. Becoming evident during the early phases of puberty and breast development, a critical time in anyone’s emotional and physical development, breast anomalies can have a profound effect on self-perception and esteem. The varying severity means that most do not share it with their parents or friends, neither a partner as they are very uncomfortable being undressed. Their quality of life and personal happiness are severely affected.
Congenital breast asymmetry and tubular breasts are two of the most common abnormalities I encounter in my practice. Congenital breast asymmetry means that you have developed two breasts of different size and shape. Tubular breasts indicate an incorrect shape which has a very narrow base and excessively large areola. It is so called tubular because it’s similar to a tube shape instead of the normal teardrop breast shape- this is because the crease beneath the breast is not placed correctly.
Breast asymmetry correction: The operation
Asymmetrical breasts can be corrected with a single operation. I always explain to the patient that the most important thing is to make them equal in terms of breast tissue volume and skin. Once I have created a good match, the shape can be improved with breast tissue remodelling techniques or implants of the same size, all in one operation.
Tuberous breast correction: The operation
With tubular breasts it can be slightly more complex as the breast tissue and skin are sometimes severely constricted from the inside. In most of the cases I do manage to release this hard tissue from inside and correct the volume with implants in one stage. Areola reduction is also done on the same day. On rare occasions I need to insert tissue expanders, which work like a balloon to stretch the skin and breast tissue. With regular inflation sessions, I add about 55 cc of volume, stretching the tissue gently. In some cases this can take several months. Once a desired size of skin pocket is reached I proceed with the second stage where I exchange the tissue expander for the breast implant and perform further tissue remodelling to give to the patient desired shape and volume. These cases can be quite challenging but immensely satisfying to see the dramatic change!
Before surgery there is always a shadow on their faces that seems to say, “I know I am different, I do not like myself. Will it ever be over? Does it have a solution?”
It’s distressing for the young woman and her family. Fast forward to post-op, I can see a completely different expression on their faces. It is a relaxed and confident smile, like a huge weight has been lifted! It is very similar to what I see after I reconstruct breast cancer patients, they struggle to believe it can be over until it is done. I particularly enjoy seeing these girls coming in with a new partner, before surgery many of them were single, so I feel I not only helped to change their body and mind but also had a positive impact on their personal life.