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    Tubular breasts

    Beauty features such as a balanced height ratio of the breast and a protruding breast are adversely affected by congenital tubular malformation. For unexplained reasons, tubular breasts have a rigid fibrous tissue that prevents the formation of a beautifully shaped breast during puberty. The different forms are divided into four or three degrees of severity (according to von Heimburg or Grolleau). Minor forms of tubular breast malformation are often only visible to the trained eye. However, slight manifestations of the tubular breast are relatively widespread.

    With mild development, the breasts are small and underdeveloped in the lower inner breast area. The malformation is more obvious if the entire lower half of the breast is reduced in size and the skin mantle is shortened. Often the lower breast fold is too high. In two thirds of the cases the breasts are of different sizes. In the case of pronounced forms, the glandular tissue of the entire breast is scarcely present and the areolas are enlarged like a tube.

    There are many techniques that can be used for correction, among others:

    • A displacement of the glandular tissue
    • A cleavage of the glandular body
    • An interruption of the narrowing breast tissue ring
    • One implant insert
    • An autologous fat treatment
    • A reduction in the areola of the nipple

    The challenge is to select the right surgical technique from the many available to achieve optimal correction. Not only the different characteristics of the malformation, but also the patient’s goals, age and overall physique have to be taken into account. Treatment techniques often complement each other. The combination of an autologous fat treatment and an enlargement with breast implants, for example, is called hybrid breast enlargement. This combination is particularly useful in the case of tubular breast malformations, since implants are ready-made products and do not adapt to the individually very different malformations.

    How is the correction of a tubular breast performed?

    Before each operation, the patient is meticulously checked several times to ensure the greatest possible patient safety. The operation is not started until all the prerequisites have been fulfilled according to the checklist.

    Before the operation, the breasts are marked in a standing position. If the operation is performed in twilight sleep, you will be given medication that will relieve your anxiety and reduce your sensitivity to pain. If you do not sleep deeply anyway, you may feel something happening on the surface of your body.

    The new areola is marked and the excess areola skin is removed. The changed glandular tissue and the fibrous ring are split. Then the autologous fat treatment and/or the breast implant are inserted into the previously determined and prepared area. Depending on the findings, drainage tubes are inserted into the wound, which can be removed again after a short period. The wound is closed with fine sutures, which dissolve themselves after about three weeks. A bandage and a special support bra are applied.

    The outpatient procedure lasts 45 to 180 minutes. Immediately after the operation you will be continuously monitored in a so-called recovery room. You can drink something after the complete awakening and, if you tolerate this well, also eat something. Before you leave the practice, appointments for check-ups will be made and the behavioural measures will be discussed with you in detail. You will receive a comprehensive written report and a telephone number where you can reach the surgeon 24 hours a day in an emergency.

    Before, after and even during the operation you can watch movies or your favourite series with virtual reality glasses. This is not only entertaining, the distraction also demonstrably leads to less sensitivity to pain.

    How can you prepare for the correction of a tubular breast?

    • All your questions about possible complications and alternative treatments should be answered before surgery.
    • On the day of surgery, shower with a disinfectant soap (e.g. HiBiScrub® Plus, Octenisan® Wash Lotion, Prontoderm® Shower Gel).
    • Keep nicotine and alcohol consumption to a minimum.
    • If necessary, stop taking hormone-containing medication (the pill) temporarily.
    • Blood-thinning medication (e.g. ASS, Thomapyrin®) must be discontinued at least ten days before the operation after consultation with your treating physician.
    • Vitamin preparations (A, E) and dietary supplements (omega-3 fatty acids, St. John’s wort preparations, etc.) must be discontinued at least four weeks before the operation.
    • Surgery limits the ability to travel by air. Therefore, do not plan any professional or private air travel during the four weeks following the operation.
    • Before performing aesthetic surgery, you should take out follow-up insurance.

    What do you need to keep in mind after you have corrected a tubular breast?

    • This is followed by regular checks of your well-being and the results of the operation.
    • An elevation of the upper body of about 30 degrees (also during sleep) over five days is beneficial for the reduction of swelling and wound healing.
    • In order to avoid slipping or twisting of the implants, it is important to sleep only on your back for six weeks.
    • Showering is possible immediately before the wound check from the third postoperative day.
    • Previously fitted support bras should be worn continuously for six weeks.
    • From the third postoperative week onwards, several daily massages for a few minutes in a circle and lengthwise and crosswise to the course of the scar with oily creams (e.g. Bepanthen® ointment or Linola® fat) help to inconspicuous scars.
    • Bending down, lifting heavy loads, swimming, sauna, sexual intercourse and sports activities should be avoided for four weeks, possibly longer if swelling still exists.

    Author’s statement

    Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

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