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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 with a special pen while the patient is in a standing position. If the operation is performed under twilight sleep, you will be given medication to relieve your anxiety and reduce your sensitivity to pain. If you are not already in a deep sleep, you will at most feel touches on the surface of your body.

    The new areola is marked and the excess areola skin is removed. The altered glandular tissue and the fibrous ring are split. The autologous fat treatment and/or the breast implant is then inserted into the previously determined and prepared site. Depending on the findings, the treating surgeon inserts drainage tubes into the wound. However, they can be removed after a short while. The wound is then closed with the finest sutures, which dissolve themselves after about 3 weeks. In addition, a bandage and a special support bra are applied to the patient.

    The operating time of the outpatient procedure is approximately 45 to 180 minutes. Immediately after the operation, you will be transported to a recovery room and continuously monitored medically. You may have a drink after you fully wake up and if you feel well you may already have some food. Check-up appointments will be made with you before you leave the practice. In addition, you will receive a comprehensive written report, you will be explained the behavioral measures for aftercare and you will be given an emergency telephone number. Under this number you can reach the surgeon in case of emergency 24 hours a day.

    Thanks to virtual reality goggles, you can watch movies or a favorite show at CenterPlast while you are being operated on. On the one hand, this is entertaining, but the positive effect goes far beyond that: the distraction caused by the glasses has been proven to lead to a reduced 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 the operation.
    • 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.
    • 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.
    • 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.
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    The author

    Dr. med. Stéphane Stahl

    “We provide you with extensive expert knowledge so that we can work with you to select the best possible treatment path.”

    Dr. med. Stéphane steel is the former director of the Clinic for Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery at the Lüdenscheid Clinic. Dr. Stahl studied medicine at the Universities of Freiburg and Berlin. In 2011 he passed the European and 2012 the German specialist examination for plastic and aesthetic surgery. Further specialist qualifications and additional qualifications followed (including quality management, medical didactics, physical therapy, emergency medicine, laser protection officers, hand surgery) as well as prizes and awards. In 2015 he completed his habilitation in plastic and aesthetic surgery in Tübingen. He is an experienced microsurgeon, a sought-after expert and a regular speaker at specialist congresses. After a multi-stage selection process, Stéphane Stahl became a member of the American Society for Aesthetic Plastic Surgery (ASAPS), one of the world’s largest and most influential specialist societies for aesthetic surgery. His authorship includes numerous articles in respected peer review journals and standard surgical textbooks.

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