• Tuberous breast or constricted breast is a congenital abnormality in the breast wherein the base of the breast is smaller leading to the lower part of the breast higher than the other breast. The breasts are smaller in size. However, the size of the areola surrounding the nipple is much bigger.

Fig 1.1 Normal Breast Fig 1.2 Tuberous breast in which the base of the breast is constricted and the position of the infra mammary fold is higher. The size of the areola is larger as it herniates through the constricted envelope.

• Tuberous breasts develop because there are abnormal fibrous adhesions between the breast and the tissues surrounding the breasts. These abnormal fibrous adhesions surrounding the breasts prevent the breasts from growing into a fuller and rounder shape. As the fibrous adhesions are mostly present in the lower pole, constricted breasts are more common in the lower portion of the breast.

• Women like to get the tuberous breasts treated because of the abnormal size and shape of the breast. The breast is much smaller in size, and the breast can be long and narrow. Many women also do not like the size of the big areola in the breast in the small long and narrow breast.

• We would examine the patient and discuss with the patient as to what she is bothering her and what she would like to get changed. Women can either want their size or shape of their breast changed, or they may be bothered about the bigger size of the areola surrounding the nipple. Most women are bothered about the shape of their breast. We would need surgery to correct these breast deformities. The incision is made around the areola of the nipple, and the constricting fibres around the breast are scored. As the breast is in a higher position, we would lower the inframammary fold or the lower pole of the breast. This would give a good shape to the breast. If the patient would also like to have a larger breast, then a breast implant is placed beneath the breast to make the breast larger. If the size of the areola is large, then this would need a reduction in the size of the areola. This procedure could be done in one stage or two stages few months apart.