Dermatology

What you should know about tubular breasts

While almost every woman and man may have some differences in the size of their natural breasts, people with tubular breasts may experience more significant differences.

Tubular breasts may appear elongated in shape, be overly “droopy,” or have very large or protruding nipples with a larger-than-normal areola (the pigmented skin around the nipple).

Sometimes the condition causes one breast to be misshapen, while other times, both breasts are affected.

Fast facts on tubular breasts:

  • The condition can range from mild to severe.
  • A woman may see a doctor for breast asymmetry due to a tubular breast or breasts.
  • Both men and women can have tubular breasts.
  • Surgical correction of tubular breasts is a treatment option.

Definition of tubular breasts

Tubular breasts
Tubular breasts may cause stress and anxiety for women.

Additional names for tubular breasts include the following:

  • conical breasts
  • tuberal breasts
  • constricted breasts
  • domen nipple
  • lower pole hypoplasia
  • snoopy breast

According to one study published in Current Concepts in Plastic Surgery, many women visit their doctors for breast asymmetry that is actually due to tubular breasts. In some instances, the disorder can cause a person significant anxiety and stress.

Treatments are available to correct tubular breasts, and the approach depends on what shape the breasts are.


Symptoms of tubular breasts

Breasts can come in all shapes and sizes, which is usually determined at the time of puberty. Tubular breasts can be any size and have some general characteristics in common. These include:

  • Breast tissue that is cylindrical instead of rounded. The tissue is usually the same shape from the base of the breast to the end.
  • Constriction of tissue at the base of the breast.
  • A saggy appearance to the breast or breasts due to an abnormally elevated lower breast fold (where the breast meets the chest).
  • Areola hypertrophy, which is when the areola is larger than normal.
  • Sometimes only one breast is affected; a tubular breast can appear undeveloped compared to the other breast. In other people, both breasts are irregular in shape.

Some doctors classify tubular breasts into three category types based on multiple features observed, such as in the example below. These include:

Type Base Breast lower fold Breast glandular volume Degree of breast drooping Skin envelope Areola size
Type I Minor constriction Minor elevation medially (inner part of breast) Minimal to no deficiency in the lower medial breast quadrant Mild to severe Sufficient Enlarged
Type II Moderate constriction Elevation on medial and lateral (outer part of breasts) sides Moderate deficiency in both lower breast quadrants None or mild Insufficient in the lower part May be normal or have mild-moderate herniation
Type III Severe constriction Elevation of entire fold or fold absence Severe deficiency in all four breast quadrants Mild to moderate Insufficient overall Severe herniation

Other doctors may choose to use a different classification system for categorizing tubular breasts. The von Heimburg classification has four categories that look at specific breast features, including the degree of deficiency of breast glandular volume, the skin in the breast below the areola, and how constricted the breast base is.

If a person desires surgery to correct their breast(s), a doctor will use one of the classification systems to identify which type of tubular breast a person has. This will help them determine the best surgical treatment approach

What are the causes of tubular breasts?

ultrasound scan of baby fetus in the womb
Some studies suggest that tubular breasts may be passed on genetically.

Doctors Rees and Aston first described tubular breasts in 1976, but researchers still do not know precisely what causes the condition.

Currently, doctors have not confirmed a genetic link between tubular breasts. If a person’s parent or a close relative has tubular breasts, there is no evidence that the person will be at any greater risk of developing it.

However, a study published in the Canadian Journal of Plastic Surgery, suggested a genetic link when tuberous breasts were identified in twin brothers.

The same article suggests that tubular breasts are caused by an excess of collagen in the fascia and the other connective tissue components inside the breast. This results in abnormal gland development that changes the breast’s shape.


Risk factors

Doctors do not typically associate tubular breasts with any other breast problems. Although tubular breasts may not cause physical problems, they can have damaging effects on a person’s mental health.

People who have one or two abnormally-shaped breasts can develop great anxiety in their friendships and romantic relationships. A person may feel uncomfortable in their clothes and may fear that others will find out they have tubular breasts.

Treatments

Breast implant for tubular breasts
Plastic surgery may be recommended to correct the appearance of tubular breasts.

Since 1976, when tubular breasts were first described, doctors have developed and improved surgical techniques to improve tubular breasts.

Because tubular breasts do not threaten a person’s overall health, many people do not seek medical treatment for the condition.

However, approaches are available that can temporarily or permanently correct the appearance of tubular breasts.

For example, a woman may choose to wear extra padding or inserts in her bra to make her breasts appear more symmetrical. For a more permanent solution, plastic surgeons can perform procedures to correct the tubular appearance of the breasts.

Doctors can take a number of approaches to corrective surgery. One such surgical technique includes:

  • Making an incision running from the bottom of the areola to the back of the breast.
  • Forming a new lower breast fold and lower glandular flap.
  • Inserting an implant into the breast area.
  • Closing up the surgical site with sutures.

Sometimes, a surgeon will also correct the appearance of the areola, reducing its size.

Often, a surgeon can correct the breast’s appearance in one surgery. However, if someone has breasts that differ significantly from each other, a doctor may recommend a two-step procedure.

In the first procedure, the surgeon will place a tissue expander in the chest; the second procedure involves fitting the implants.

Any person considering surgery must be aware of the risks involved. Risks from the procedure include bleeding, scarring, infection, and risk of further deformities.


Takeaway

For some people, tubular breasts can be a source of anxiety and mental discomfort. Although tubular breasts are not harmful from a physical health standpoint, an individual may desire surgery to make their breasts appear more symmetrical.

According to a chapter in the book, “Current Concepts in Plastic Surgery,” correction of tubular breasts can help a person build self-esteem and enjoy their social life more.

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