DR. MARTIN J. GIUFFRE (B.MS., MD., F.R.C.S.(C))

Breast

congenital deformity reconstruction

BEFORE & AFTER PHOTOS

*DISCLAIMER: This site contains graphic & surgical images that may be disturbing to some viewers.

This site is intended for individuals over the age of 18.

**Please note that none of the images posted throughout this site have been enhanced or photoshopped.

Congenital deformity reconstruction for abnormal breast development

What is a normal breast? 

Both breasts are very similar in size and shape. This is called symmetry.

40% of the breast volume lies above the nipple areolar complex and 60 % below. The nipple areolar complex is at the apex of the breast mound with a gentle lower and lateral curve of the breast mound meeting the chest wall, at a defined crease, which matches the opposite breast.

There is no “normal “breast size although the average North American Breast size would range between 400 – 450 grams.  There is a huge range of breast sizes and shapes.

What about an abnormal shaped breast?

The female breast begins to develop in the peri-pubertal age (8-16 yrs.) and the breast development is completed by the age of 19 yrs. The development of both breasts is similar, although, to have two perfectly symmetrical breasts is uncommon (about 5%).

There are congenital conditions where the breast does not develop at all, or, it only develops on one side and not the other. This can be accompanied by little or no development of the muscle behind the affected breast (this is called Poland’s sequence). The nipple may also be absent, or abnormal, in size and location.

There are conditions where the breasts (one or both) do not develop properly resulting in an abnormal shape, different nipple heights, and different size breasts (this is called Tuberous breasts).

What if I have normal breasts but they are different in size and shape?

*Please refer to FAQ Breast Asymmetry

What if I have no breast development on one or both sides?

An assessment during a consultation with Dr.Giuffre will help define the deformity and determine what surgical approach is required to address the deformity.

  • If there is normal musculature under the breast, with no breast development, then this would be approached in a similar way to reconstruction after breast cancer. Depending on how much skin laxity is on the chest wall, and the patient’s desires with respect to breast size, then the surgical options may include inserting an implant.

    *Please see FAQ: Breast Augmentation for the female breast

  • If the patient wishes to have larger breasts than what the tissues on the chest wall will accommodate, then a staged reconstruction is done using a temporary tissue expander implant, which slowly stretches the tissues of the chest until the desired size is achieved. A second surgery is then done after 3 months to remove the temporary tissue expander implant, and replace it with a permanent (saline or silicone) implant.

    *Please see FAQ: Breast Reconstruction following Breast cancer

What if I have no muscle and no breast on one side of my chest wall?

This is a congenital condition that may also be associated with abnormalities of the extremities on the same side as the chest deformity, and may also involve same sided facial and eye abnormalities. It is called Poland’s Sequence. The cause is unknown. It is often diagnosed before school age. It can occur in both males and females. A complete medical assessment would be recommended before any surgical consideration. 

  • As the female approaches puberty, the unaffected side will have normal breast and nipple development. The affected side may have no breast development, or a small amount of development, or, an abnormal and asymmetrical breast development. The nipple may be absent, in a different position, be a different size, or may be unaffected.

  • The reconstructive approach, and timing of surgery, is very individual depending on how fast the breasts are developing, the size of the normal breast development, and the patient and her parent’s desires.

  • A complete assessment and treatment plan is discussed with the patient, and her parents, if surgical intervention is contemplated before the age of majority (18yrs.).

This often will require more than one surgery

  • If the patient waits until the normal breast is fully developed before considering surgical intervention on the affected side, then a surgical plan is discussed with Dr. Giuffre during a consultation. This may involve a combination of all the surgical techniques used in Breast Reconstruction following Breast cancer.

  • In all instances, during the consultation with Dr. Giuffre, an outline of the surgical options and risks would precede any surgical intervention.

What if one or both of your breasts have an abnormal shape, called a Tuberous Breast deformity?

A Tuberous breast deformity can occur on one or both breasts. **Please refer to the photo stream above.

There are varying degrees of the deformity from mild, which only affects the nipple, to severe, which produces an abnormal “snoopy dog” shaped breast deformity. Each degree is classified based on the severity of the deformity.

Most often, there is also breast asymmetry with one breast affected more than the other.

This is a developmental deformity and has nothing to do with a patient’s diet or lifestyle.

It is apparent at puberty and worsens with breast growth. The deformity is stable at the completion of breast growth (age 19yrs.)

Surgical intervention to correct the deformity is delayed until full breast growth is completed.

Consultation with Dr. Giuffre before breast growth is completed is recommended, in order to formulate a plan and timing for reconstruction. 

Prior to any surgery, further consultation with Dr. Giuffre to review the details of surgery, and the risks associated with each procedure, would be reviewed.