Hypoplastic Breast Anomalies in the Female Adolescent Breast

Abstract

Hypoplastic breast anomalies remain a reconstructive challenge. In this article, the authors review the spectrum of nonsyndromic breast hypoplasia in the adolescent girl, namely idiopathic breast hypoplasia and tuberous breast deformity. Challenges specific to this population include (1) identifying the ideal timing for surgery, (2) choosing the optimal reconstructive method while taking into consideration ongoing changes in the female body (e.g., future pregnancy), and (3) considering the use of a two-stage reconstructive approach to gradually expand the skin envelope. A comprehensive review of surgical techniques that address these conditions is provided, taking into account the evolution and the most recent advances in surgical techniques.

Reconstruction of Acquired Breast Hypoplasia by Subcutaneous Scar Releasing and Repeated Fat Grafting Combination

“…BH treatment includes autologous methods, breast implants, or both. 1 Scars with fibrotic bands may restrict breast growth, especially in postburn deformities. Similar scars may occur in healing processes after breast infections.…”

“…Z-plasty, excision, scar releasing, skin grafts, flaps, tissue expanders, and fat grafts are useful reconstructive alternatives in the treatment of fibrotic and restricted scars. 1 – 3 …”

“…The acquired causes include burns, irradiation in childhood period, cutaneous hemangiomas, childhood traumas, and infections, which result in breast scars. 1 , 2 Breast implants, autologous tissues, or both are options in the BH reconstruction. For secondary deformities such as traumatic or postinfectious scars, Z-plasties, scar excisions, or relaxations, skin grafts and flaps can be used in addition to basic breast reconstruction techniques.…”

Tuberous Breast

“…Tuberous breast is a rare deformity 1 with onset at the beginning of pubertal growth. [1][2][3] The main signs are hypoplasia and tubular shape of the breast, which may be uni or bilateral, symmetric or asymmetric. 2,3 The diagnosis is clinical and the treatment is surgical.…”

Invited Discussion on: Autologous Fat Grafting with Percutaneous Fasciotomy and Reduction of the Nipple–Areolar Complex for the Correction of Tuberous Breast Deformity in Teenagers

“…The age of intervention appears to be early despite the patient's achievement of Tanner stage V as the average age was 14.9 years, whereas the breast size may continue to grow for several years. In our practice, if a patient in this age-group desires tuberous breast correction, we initially focus on the four primary structural characteristics of tuberous breasts [4]-narrow breast base width (BBW), underdeveloped lower pole, short nipple to IMF distance, and herniation of the breast parenchyma through the areola of the tuberous breast deformity. We would like to limit the amount of fat transferred in the adolescent period.…”