Consequences of Congenital Breast Anomalies

Although a congenital breast anomaly or tubular breast deformity would not have any functional implications, its psychological consequences on an adolescent patient can be tormenting. Following are some major consequences which can hamper a patient's confidence and peace of mind:

• The patient can experience embarrassment.
• Social isolation, in rare cases, can be mentally torturing.
• The patient can experience complexities in sexual development. As the body grows, the usual puberty changes might be hampered.
• The patient can experience trouble in sexual life, which can badly affect the happiness and mental peace. It is gruesome for the patient's relationship with the partner too.
• In the long term, the patient might develop a disability as the movement of one side can be impaired.

These consequences are scary and have a negative impact on the psychology of the patient. Therefore, it becomes imperative for the patient to seek tuberous breast deformity treatment or other breast anomalies treatment. The impact of the problem will be lessened by the timely surgical intervention so that the patient can lead a normal life.

The Approach Of The Cosmetic Surgeon

The breast anomalies can be complex at times, which can pose a technical challenge for the surgeon. Hence earlier the age, the better and easier it becomes to get the following corrective procedures done:

• Aesthetic Intervention
  The cosmetic surgeon understands the importance of the aesthetic appeal of breasts. Hence they focus on rectifying the shape and symmetry of the breast with the other. They conduct several examinations to ensure that the results are as close as possible to natural breasts.
• Functional Intervention
  The breasts play a great role functionally in the body of the patient. An adroit cosmetic surgeon aims at functional reconstruction so that sensation and lactation of the patient are restored.

The Frequency Of The Surgeries

The patients suffering from any kind of breast anomaly by birth seek help at the age of puberty. This is the time when the anomaly manifests itself peculiarly. Patients of this age are more aware of body defects.

In case the patient is a child with a severe anomaly, the defect can be cured in a single intervention or may even require more than one surgical corrective procedure over a number of years.

Types Of Congenital Breast Anomalies

Following are the major of breast anomalies that can occur from birth:

1. Poland syndrome

This syndrome means a lack of muscle development on one side of the body. Also known as Poland anomaly or Poland sequence, it means the lack of chest muscle walls in the body one side and hence lopsided breasts. This anomaly implies either of the following:

• Absence of lower part of the pectoralis major
• Hypo or Aplasia of breast and nipple
• Reduced fat in the armpit
• Abnormality of the ribs where the nipple is placed high
• Elevated Shoulder Blade
• Underdeveloped Ribcage

The causes of Poland Syndrome are not specific but this can be due to underdevelopment of arteries in pregnancy which affects the growth in structures of chest and arm. In girls, the anomaly is sometimes highly significant. The breast is hardly developed.

What is the cure?

The surgeon takes note of anatomical structures that are not well developed and the aesthetic and functional irregularities. It is recommended to undergo reconstructive plastic surgery/ tubular breasts surgery/ tubular breasts deformity surgery.

At the beginning of puberty, the cosmetic surgeon places a tissue expander under the skin so that the skin stretches enough to match the other side.

After puberty when the breast is fully developed, the surgeon replaces the expander with a permanent implant. This is the corrective breast reconstruction surgery where the existing chest wall muscles or other muscles throughout the body are used to fill the missing portions.

2.Supernumerary Breasts and Nipples

This minor congenital malfunction is a relatively common case where one or more nipples are present in an unusual location. The nipple may be small, looking more like a birthmark. The extra nipple is present on the natural nipple or the milk line, extending from the axilla to the pubic region.

Supernumerary breasts are also called accessory breasts, which may occur with or without areola. Larger supernumerary nipples occur in aninframammary fold and are usually associated with the development of an extra breast. Such changes are more prominent during or after puberty. This problem does not cause functional malfunctioning,however.

What is the cure?

Undesirable or symptomatic supernumerary nipples are surgically removed with complete surgical excision. Breast tissue before the nipple is removed. The scars are generally minimal. It is usually an outpatient surgery where the patient is not required to stay overnight in the hospital.

3. Aplasia- Absence of Breast and Nipple

This is a disease that affects a child while in the womb. It shows effect while in puberty by the absence of one or both nipples. Worse still, as the patient ages, the breasts do not develop further. Since the formation of mammary gland and nipples are interconnected, the breasts also do not develop in the absence of nipples. However, there is a chance that small nipple with little or no breast tissue underneath develops.

In either case, the patient has to seek help to get back the most important gland in the body. This has aesthetic as well as psychological implications. This is possible in the hands of a cosmetic surgeon with the help of breast reconstruction.

What is the cure?

Breast Reconstruction is vital for good mental quality of life. For patients in puberty,the following steps are undertaken:

• Preoperative examinations are done and endocrine-related diseases are checked for. Breast MRI is done to assure the absence of breast tissue.
• After explaining the protocol to the patient, a tissue expander is inserted into the sub muscular layer of the affected side of the pectoralis major. The tissue expander compensates for the lack of skin or breast tissues initially.
• This is an outpatient process where the patient is not required to stay overnight in a hospital.
• If the patient is in the middle phase of growth, breast reconstruction intervention is done by inserting silicone breast implants. The silicone breast implants match the growth of the affected side with the unaffected side.

How will you choose the Cosmetic Surgeon and the Clinic?

For a technical intervention like the congenital breast anomalies, where there may be more than one surgery required, choosing the right cosmetic surgeon and the perfect clinic is of paramount importance. You need to check the following credentials to assure that you are at the right place:

• Check for the qualifications and certifications of the cosmetic surgeon.
• Make sure the doctor is a member of the cosmetic surgery branch.
• Assess the number of successful surgeries done.
• Also, the experience of the surgeon matters. This means the surgeon must have performed a good number of similar interventions in the past.
• The amicability and hospitability of the staff, the ambiance of the clinic and the approach of the surgeon play an important role in choosing an expert surgeon.

Breast Lift And The Size Of The Breasts

Breast lift impacts the position of the breast and doesn’t affect the size of the breasts. However, there are two separate surgical processes called Breast Augmentation (also called augmentation mastopexy) which enhances the breast size or Breast Reduction (also known as reduction mastopexy) which minimizes the breast size. These surgeries aim at reviving the desired breast size and breast lift can be performed in conjunction with these interventions. Either of these surgeries can be done along with breast lift to get the desired cup size and position of the breasts.

Pre-Breast Lift

You need to consult your cosmetic surgeon before considering a breast lift. The surgeon shall assess you and take note of your medical history along with your expectations. The implications and complications of the surgery will be duly discussed and the surgeon will apprise you of the precautions you need to take care of after the surgery.

Be specific about your expectations and what bothers you particularly about your breasts.

During The Breast Lift

It isn’t a very complicated procedure if approached correctly. The position of the nipples and areolas are marked, anesthesia is administered and the surgery is done. The surgeon will remove extra flaccid skin and lift up the breast tissue to the proper location.

1. The surgeon will first mark the position of the nipples at its raised best while you are standing.

2. Anesthesia helps to relax and relieve pain. In general anesthesia you tend to sleep during the surgery.

3. The surgeon then makes an incision around the areola. The cut can be extended down the front of the breast from bottom of the areola to the crease.

4. Extra skin is then removed so that the breasts can appear firmer and protruding at the front.

5. With the help of stitches and skin adhesives, the incisions are then closed. These incisions are made at places where they aren’t usually visible.

Breast lift can be accompanied by breast augmentation or reduction surgeries. The aim of all the procedures is to give you the desired breast fullness, volume and position.

Post-Breast Lift

Following are some points which you need to take note of post the surgery:

1. Pain medications might be needed. Wear the bra or the support dressing as recommended by the surgeon.

2. You can resume work within 7-10 days. A week-off from work would suffice for recovery.

3. Follow the medications and diet as specified by the surgeon.

4. Stay-off from smoking. Smoking can cause wound-healing delays.

5. Avoid heavy lifting for at least a month and a half for recovery to be undeterred.

With these precautions, the healing and recovery will be faster. You need to adhere to the specifications prescribed by the surgeon.

Repeat Breast-lift: Some women might need a repeat breast lift as a part of the ‘touch-up’ procedure to improve the minor defaults and further enhance the overall appearance.