Congenital Breast Abnormalities
There are several congenital breast abnormalities which may result in breast under-development, asymmetry or unusual shaped breasts. It is also not uncommon to have mammary tissue or extra nipples in abnormal locations or, more rarely, a complete absence of breast tissue. Typically, these conditions become apparent in adolescence but can be diagnosed at any age.
Tuberous breast anomaly
Tuberous breast anomaly is a common congenital condition that is named for the typically elongated or tubular appearance of affected breasts, however, it can present in a variety of ways. Many women are unaware of the condition until consulting with a specialist, and are relieved to find there is an explanation for their breast asymmetry or unusual shaped breasts. Many patients seeking breast augmentation surgery have tuberous breast anomaly, and it’s recognition avoids potential pitfalls in surgical planning.
Typical characteristics associated with tuberous breasts include asymmetry, abnormally wide cleavage, a higher than normal inframammary fold (the crease formed by the fold under the breast), and large puffy areola due to a herniation of the breast tissue into the areola complex. Tuberous breasts will often have a narrow, conical “constricted” appearance, but may also display under development of one or more quadrants of one or both breasts. Presentation varies from mild abnormalities to more severe, and will differ between individuals and often between breasts in the same person.
Poland’s syndrome is a congenital anomaly of the chest wall which can result in absence of part of the pectoralis muscles, rib and breast tissue. This is often not noticeable in childhood but may become apparent when the breast on the affected side does not grow at the same rate as the normal side.
Polythelia is the term for supranumerary (extra) nipples or areolae. It can occur in up to 5% of the population and is sometimes misdiagnosed as other skin lesions. Polymastia is the development of accessory breast tissue, most common in the armpit (axilla) but can be anywhere on the body. This often only becomes apparent after hormonal changes in puberty or during lactation
If you believe your breasts display the characteristics of a congenital breast abnormality and it is something you would like to discuss, one of our plastic surgeons would be pleased to meet with you. At the initial consultation you will learn about options for management appropriate to your individual situation. Breast surgery to correctly and safely reconstruct congenital breast abnormality is often not just a straightforward breast augmentation. There are many factors to consider in order to safely and correctly achieve desired aesthetic results. Our specialist plastic surgeons have the skills and techniques to plan each patient’s surgical journey uniquely, catering to your individual needs.
The Procedure + Surgical Techniques
There are a variety of methods that can be used to correct congenital breast abnormalities, and it is sometimes necessary for these to be performed in stages. Your plastic surgeon will work with you to develop a surgical approach that will best achieve the aesthetic result you are after. Find comfort in knowing our surgeons are skilled in the latest techniques and applications for all breast surgery.
Breast surgery to correct congenital breast abnormalities is highly individual. It may require removing or rearranging some of the existing breast tissue, or augmenting an under-developed breast. The surgical correction of congenital breast abnormalities can be quite complex. For example, in tuberous or under-developed breasts, surgery may involve a two-stage approach. Tuberous breasts typically have a short distance between the breast fold and the nipple. Using a temporary device called a tissue expander in the first of a two stage correction, permits the skin of the lower part of the breast to slowly stretch out. This minimises stretch marks and provides balance to the breast by adding volume back to the area that is missing. A two stage procedure also gives patients some autonomy over the size, shape, look and feel of their reconstruction. The final result can be then be planned, usually with an implant and/or fat grafting procedures. Some patients require a breast lift and/or an areola reduction in this operation to improve symmetry and balance.
Hospital Stay and Anaesthesia
For reasons of patient safety, the correction of congenital breast abnormalities is nearly always performed under a general anaesthetic with an anaesthetist present. Some small procedures may be done under local anaesthetic only. Surgery can take place as a day procedure, but in some instances an overnight stay is required. Your plastic surgeon will discuss this with you during your initial consultation.
In order to keep your consultation as smooth and efficient as possible, we ask that you bring all relevant documentation with you on the day or send it in to our practice beforehand. This includes your referral letter, Medicare card, private health insurance details, any third party or insurance information and any relevant scans such as x-ray or other radiology scans and reports.
During your initial consultation with one of our specialist plastic surgeons, you will have extensive opportunity to discuss expectations and desired results. You will also have the opportunity to ask any questions you may have about the procedure itself.
You will then meet with one of our experienced breast care nurses, where you will have clinical images taken as a before and after reference for both yourself and your surgeon. All all our images are confidential and are stored securely online pursuant to the current Privacy Act. Your breast care nurse will take your measurements and fit you for a post-operative bra.
The final stage involves meeting with your surgeon’s personal assistant. You will be provided with an in-depth quote, including the fees for the surgeon, hospital and anaesthetist. When your surgery is booked, you will be given a pack which includes further details and instructions regarding your procedure.
We recommend that you allow an hour for the initial consultation. Please keep this in mind when organising parking so that you don’t feel the need to rush.
There is a lot of information to take in after your first consultation. We encourage our patients to go home and discuss their procedure with loved ones and come back for a second visit. We find many patients have additional questions and this second visit also allows you to discuss expectations for surgery and confirm the peri-operative plan, so you feel confident and fully informed about your procedure.
Before your procedure
There are a number of things you can start to implement before your procedure, to encourage a smooth recovery and ensure you are as comfortable as possible post-surgery.
It is important that you:
- Exercise – having good physical health will significantly help your recovery
- Are not currently pregnant or breastfeeding or planning a pregnancy soon
- Provide a complete medical history to your specialist plastic surgeon, including all current medications, as some may need to be stopped prior to surgery.
- Quit smoking
- Arrange for someone to look after you during your recovery. You will need someone to transport you to and from surgery, as well as stay with you for 48 hours after returning home after a general anaesthetic.
- Ensure you follow pre-operative instructions, such as fasting times and stopping some medications, or your procedure may be cancelled
- Have plenty of loose comfortable clothing that is easy to get in and out of post-surgery
- Prepare your recovery nest. You’ll want to have everything you need easily accessible and within arm’s reach. We suggest comfortable pillows, cool packs, prescribed medications, healthy pre-prepared meals and snacks, a list of emergency contact details, phone and device chargers as well as things to keep you entertained
The time frame for recovery will vary depending on your procedure, your general health and fitness, and extent of surgery. Your return to work depends on the nature and physical exertion required for your job. Your surgeon will discuss this with you prior to surgery, and it is important to allow yourself the recommended recovery time. Vigorous activity and exercise should be avoided for the first six weeks, however gentle walking is encouraged after the first week.
On discharge, you will be given specific postoperative instructions to facilitate recovery, and a follow-up appointment will be made with your plastic surgeon. These instructions will cover everything you need to know in order to make your recovery as smooth and comfortable as possible.
Post-surgery it is common to have some bruising and swelling, as well as a feeling of tightness if you have an implant placed. This is perfectly normal, and while these issues typically subside within the first two weeks, they may persist for up to a month. Breathable tape dressings are applied across the incision lines, and these will remain until your first post-operative visit. You should be able to shower with these dressings on and pat them dry.
You may be required to wear your postoperative bra day and night for up to six weeks from the day of your surgery. The bra helps control the bruising and swelling, gives you support and helps reduce your pain. Patients often purchase two post-operative bras, to allow one to be laundered while the other is worn.
A plastic tube and collection bottle may remain post operatively to drain off excess fluid. These stay in place until the drainage slows and are removed by a nurse usually a day or two after your surgery. Most of the sutures used will be dissolvable, however any other sutures will be removed on day 10–14. Occasionally half your sutures are removed at this visit, and the other half are removed the following week.
Please be assured that our team is here to support you in making a swift, uncomplicated recovery. We offer a 24/7 on-call medical assistance service for all our post-operative patients.
Breast Implant Registry
Our surgeons are pleased to participate in The Australian Breast Device Registry (ABDR). The registry is designed to track patient health outcomes, monitor the long-term safety and performance of breast devices and benchmark the quality of surgery involving breast implants.
If you would like more information please click here.
Ready to book an initial consultation?
If you are ready to book your initial consultation, please book online or call us to book with one of our helpful team members. We’ll be pleased to help you start your journey.