

Tired of hearing about the breast??? This week I want to talk about the less than perfect breast that some women develop. I know many of you women are tired of hearing about the perfect breast that is just a little small and can be made better by implants. What about the breast, due to genetics, or abnormal development, cannot be helped by implants alone?? Let's talk about that today to give you a break! However, I don't want you to forget about our breast enhancement special...it only lasts until April 30 so you have to act quickly. Click the button below to get the details!!
Let's see how the breast develops normally, then we'll have a better appreciation for how these deformities can occur. Then we will cover how we fix them to make the breast look more normal. The normal breast is stimulated to form by female hormones that begin production at menarche or the start of menstruation. The picture below shows the normal progression of the breast as it grows from a bud that men AND women have. Again, it is the female hormonal soup that causes them to form.

Of course it is very rare for both breast to form exactly the same. Perfect symmetry in the body is rare, so each breast is different, even in the same person. This is why some women have difficulty finding a properly fitting bra. There may be a half cup difference between sides.....this is not abnormal....just aggravating! Here is a picture of different breast shapes and sizes. This does not include all types of course, but it gives you an idea of how many variations of normal there are and also includes some of the abnormal breast shapes.
(the "perfect" breast shape is a misnomer of course)
As you can see from the first picture, the breast bud starts first and develops concentrically, widening to form the breast mound. If this concentric expansion is retarded, the breast forms as a tube, making the very constricted and abnormal looking. The function of the breast is also retarded and in most cases, breast feeding later in life is not possible.
This picture is a depiction of tubular breasts of different severities. It is the mound of the breast that is constricted and does not spread out, therefore, the tubular shape of the breast.
The other feature of the tubular breast deformity is a herniation of the nipple. Normally, as the nipple and areola develop, they are "puffy". The nipple is puffy until the breast mound spreads out. As this happens, the nipple-areolar complex flattens to create the more "normal" appearing breast as a whole.
Herniated "puffy" nipple.
So now that we know what a tubular breast deformity is.....what can be done about it? To fix this problem properly, we must address several issues. First, is the nipple herniation. Fortunately, fixing the nipple also gives us access to the rest of the problem and allows the entire fix to be done through one incision. We use the peri-areolar incision to make the nipple smaller and to allow access to the tubular, constricted, breast tissue below.
This incision allows us to reduce the nipple size and when closed it flattens the nipple and areola into a more normal appearance. The constricted breast is broken up below so that it is no longer in a tube shape and lays flatter.
The last step is augmentation. Since the breast only formed centrally, there is generally very little volume. This can only be corrected by adding volume with an implant. We place the implant below the muscle and through the same incision. Saline implants or silicone implants are used as there is no difference in the result...again...it is personal preference.
The results are generally very good. It does take some time for the skin to stretch and accomidate the new volume. There also may be some creasing of the skin, usually the lower part of the breast, due to its tight adherence to the chest wall, that may take some time to stretch. This skin may never stretch fully. The goal is to get as near a normal appearing breast as possible. This is not always achievable but any improvement is usually greatly appreciated. The incisions heal nicely and the recovery time is about that of a breast augmentation.
Good representation of tubular breast deformity repair.
Come see us today for all of your Cosmetic surgery, Vein surgery, Obesity surgery, and General surgery needs. All Cosmetic Surgery Consults are complimentary, call 918-786-7780 or call toll free 1-877-weight0. Be sure to take advantage of our breast augmentation special through April 30!!!!!





A picture of spider veins.
Picture of large varicose vein.
These pictures are a good visual for how this works.
If the valves do not work properly, pressure builds. This is reflected in the branches of the larger veins and they enlarge over time creating the large varicose veins we have all seen. These become painful as they stretch the surrounding connective tissue and the pressure, combined with the lack of flow causes the iron from the blood to break down in the skin. This can lead to rust colored changes in the skin, rashes, and eventually skin breakdown. 








The stretch marks in this photo would indicate to me that a tummy tuck would be a better choice for her...why? Her skin will have less of a chance of contracting after the fat is removed because of the poor starting skin quality. It will be more likely than not that her skin will not contract. This does not rule out liposuction for her but she must understand that, in clothes, she will look better and more sculpted, but in a swimming suit, the skin will still look bad and possibly more saggy. If her skin were smooth, she would be a much better candidate.

We start with an easy one. If you said tummy tuck, you would be right. There is no doubt there is a lot of fatty tissue present and liposuction COULD be considered, however, the hanging skin would only become worse. A tummy tuck with associated liposuction of the waist would be the appropriate choice. The tummy tuck would remove the excess skin and stretch marks below the belly button and liposuction of the waist would accent and renew the shape of the sides of the abdomen.
This one is a little tougher. When you look at this abdomen what do you see? As far as fatty tissue goes, there is only a problem area in the mid abdomen and a lower abdominal pooch. Normally, this would be a perfect abdomen for liposuction, however, you always must evaluate the skin quality too. The skin in the lower abdomen is riddled with stretch marks. For this reason, I would recommend a tummy tuck. The tummy tuck removes a majority of the stretch marks, tightens the remaining ones and moves them below the pant and swim suit line. Of course if she presented not caring about skin quality after the procedure, a liposuction procedure could be selected. I would doubt the level of satisfaction after liposuction alone.
Not exactly a clinical photo, but, it makes a point. This girl is the perfect example for liposuction. Perfect skin, nice shape overall, and just a small area of fat in the lower and mid abdomen....what a pallet!! I could make this abdomen look amazing. I would use a small cannula, remove the fatty tissue and give her some definition. I would then use the cool touch laser to tighten the skin more. It would look fantastic.
This abdomen is a little tougher. The skin looks pretty good. The shape is fair with some fatty pockets that could easily be removed with liposuction. Liposuctioning the waist would also improve her shape into a more hourglass look. BUT, what about the C-section scar? It is a point of adherence that liposuction will not address. I would recommend a mini tummy tuck with liposuction. This would allow me to tighten the lower abdominal skin, remove the C-section scar, and liposuction the waist. I would not make an incision around the belly button but remove some skin that will make it look better.






