Tubular Breasts

Tubular Breasts – Description

Tubular breasts only concern a small percentage of women who have this breast abnormality during puberty. The breast with this abnormality stops growing and its appearance resembles a tube. The cause of this malformation, to this day, has not been discovered. Plastic surgery can correct these deformities.

Tubular breasts – What are the signs?

• Asymmetry between the breasts
• Hypoplasia of the breast.
• Incorrect position of the crease under the breast.
• Swelling of the nipple, as if herniated.
• Very small breast base in the chest and usually lack of a mass gland in the inner part of the breast.

Tubular breasts – Pre-operative instructions

If breast prostheses (breast augmentation) are to be used, a size selection is made that will assist the surgeon in achieving the best possible result and subsequently satisfy the patient.

• Classic pre-operative check-up
• 12 hours before surgery you stop eating.
• 6 hours before surgery you stop drinking.
• On the morning of the operation, you do not take any medication until the anesthesiologist agrees.
• Alcohol should be stopped 1 week before the operation.
• Smoking should be stoppped at least 3 weeks before surgery.
• In case of general anesthesia, it is necessary to meet with the anesthesiologist before the surgery. You have to report previous anesthetic experiences, either positive or negative, to the anesthetist and inform him/her of any health problems or medication you are taking.
• Do not take aspirin, anti-inflammatory drugs, or herbal supplements 10 days before the surgery, as these all increase the possibility of bleeding during and after the surgery.
• 3 days before surgery and every day wash your face or body, (depending on the planned surgery), with medicated soap.
• A mammogram and/or a breast ultrasound, depending on the age of the person concerned, is necessary before the surgery.

Tubular breasts – Type of anesthesia

The above surgery is performed under general anesthesia and usually requires one day of hospitalization. The duration of the surgery is 2-3 hours.

Tubular breasts – Surgical technique

The surgical correction is usually performed by placing a silicone implant while reshaping the breast. Rarely, in severe cases of tubular breasts rehabilitation is needed two times with tissue stretching.

The plastic surgeon prepares the “pocket” under the breast where the prosthesis will be implanted, which is placed in a location that highlights the shape of the breast. The place where the prosthesis is placed is either under the mass gland or the underlying muscle.

A drainage tube is most often left inside each breast to prevent fluids from accumulating around the prosthesis after surgery. This tube is usually removed the same day or the day after surgery.

At the end of the surgery, adhesive tapes and a special bandage are applied, creating a makeshift bra that is replaced with the normal bra 48 hours after surgery.

Postoperative instructions

• After surgery, the patient may have chest pain for 3-4 days if the prostheses have been placed under the pectoralis major muscle. The pain is adequately treated with oral painkillers. In the best of cases, the patient will feel a tightness in the chest for a few days.
• Swelling is present for the first few days and gradually subsides without problems.
• A pressure bra is used for a period of 6 weeks. For the first 4 weeks, the patient has to wear the bra for 24h/24h and for the 2 final weeks for 12h/24h.
• The incision is red for the first 3 months and gradually turns white with the final result becoming visible in 1 to 3 years.
• The incision should not be exposed to the sun for the first 3 months.
• Progressive recovery of gymnastics in the breast area is allowed after the 8th week.
• The incision will not disappear completely. For the best course of the incision, massage with a cream every day. Silicone sheets locally on the incision are recommended until the desired aesthetic result is achieved.

Tubular Breasts – Complications

• Haematomas: Small bruises may occur in conjunction with blood collection under the incision. To avoid hematoma, the Plastic Surgeon must perform diligent hemostasis.
• Inflammation: To avoid this complication, we administer antibiotics, both intraoperatively and postoperatively.
• Wound opening: to avoid this complication, the wound is sutured without too much tension on the skin.
• Pulmonary embolism: This is a potential complication of any surgery, which is prevented with anticoagulant medications immediately after surgery and with immediate patient movement.
• Incision hypersensitivity: There may be decreased sensation in the area of the surgical wound, which generally returns in 3-6 months.

The lifespan of silicone prostheses

A silicone prosthesis, either gel or saline, has a specific lifespan. The companies producing the prostheses estimate it at around 10 – 15 years. This does not mean that a prosthesis cannot be changed sooner or later. The fact is that there is no guarantee that they will never be changed. A woman with silicone prostheses should be aware that there is a risk at some point to undergo a prosthesis-changing surgery. Of course, if no problems have occurred, the prostheses can remain in the breast for as long as the woman wishes.

Long-term complications of prostheses

• Creation of folds in the prosthesis

This is more common in saline prostheses, but can also occur in silicone gel prostheses. In this case, the woman sees and feels the folds of the prosthesis, mainly under and outward of the breast. To avoid this, the doctor makes enough space for the prosthesis intraoperatively. If this still happens, there are surgical solutions to solve this problem. These are decided depending on the situation because each case is different.

• Creating a capsule around the prosthesis

The creation of a capsule around the prosthesis is unavoidable. It is a normal process of the body to isolate a foreign organ. In some cases, however, this capsule can become more prominent and thick and press on the prosthesis, causing pain and deformation of the breast. There are 4 stages of this condition. The likelihood of developing a problematic capsule cannot be measured because it depends on many factors, such as the type of prosthesis and the surgical technique. In case the capsule creates symptoms, such as pain and aesthetic deformity, it should be surgically corrected.

• Opening of the prosthesis

Such a phenomenon can occur after a severe injury in the chest area, less frequently due to a mistake in the construction of the prosthesis, or more often after years due to the age of the prosthesis. In cases of saline prostheses, it may be a valve problem. In cases of silicone gel prostheses, usually, the silicone stays inside the capsule and does not diffuse into the surrounding tissues. Of course, all of this is preventable with routine and systematic breast examinations, which all women should undergo.

Breast Intentions – Results

The final result is visible 1 year after surgery. Any corrections can be made at that time, but it should be noted that absolute symmetry between the breasts does not exist, as it is impossible by nature.