Definition of tubular breasts

Tubular breasts, also known as tuberous breasts or hypoplasia, is a congenital abnormality where the breasts fail to develop and mature fully during puberty. Other less-commonly used terms for this condition include constricted breasts, herniated areolar complexes and conical breasts.

This condition results in a generalized lack of breast tissue, though its effect is not limited to this. It can occur in males and females alike, and it can present either unilaterally or bilaterally. Currently, the condition is diagnosed purely based on the appearance of the breasts; thus, the process of diagnosis can be highly variable.

Aetiology/ causes

There is currently no known definitive cause for tubular breasts. Current research suggests that it might be due to a genetically inherited disorder where the normal process of collagen deposition is disrupted. Other doctors also hypothesize that it is caused by an event that occurred in utero, when the patient was still a foetus in the mother’s womb.

Effects

The effects of tubular breasts are mainly cosmetic, and the condition does not pose any immediate health risk to patients. It has also not been shown to affect a female’s fertility or health during pregnancy. However, its effect on the appearance of a patient’s breast can be significant, and it can affect the secretory functions of the breasts in breastfeeding mothers. Furthermore, the condition can cause significant psychological distress to the patient, affecting his/ her overall well-being.

Effect on appearance

Tubular breasts significantly affect the overall appearance of a patient’s breast. The most obvious sign of the condition is a markedly smaller breast size, especially when compared to another person of similar built and age. Other presentations include the following observable signs, or combinations of these signs:

• Significantly greater distance between the two breasts. This has been defined by some sources to be greater than 1.5 inches.
• Higher breast folds than usual.
• Irregular breast shape. The breasts may seem oval shaped, pointed, or even square-like, instead of the classical round shape.
• Enlarged and swollen areola, where areola refers to the darkened area surrounding the nipples.
• Asymmetrical breasts, where one breast is larger than the other. This occurs if the condition occurs unilaterally instead of bilaterally.
• Lack of firmness of the breasts, causing them to sag.

It is important to bear in mind that different people might have varying presentations for this same condition. Furthermore, there are no fixed criteria to diagnose tubular breasts.

Effect on breastfeeding mothers

Apart from the cosmetic effects mentioned above, having tubular breasts might also inadvertently reduce milk secretion in post-partum females, thus affecting regular breastfeeding. Such mothers might rely on formula milk to feed their babies instead. It is important to bear in mind the numerous benefits of breastfeeding to both the baby and the mother. For example, a mother’s breast-milk is more nutritious than formula milk and can provide the new-born baby with transient immunity. Furthermore, breastfeeding reduces a mother’s risk of post-partum depression, as well as breast and ovarian cancer in the long-run. If the condition of tuberous breasts hampers the ability of post-partum mothers to breastfeed their babies, such benefits cannot be reaped.

Psychological effect

In addition to the physiological effects associated with tubular breasts, the condition can also have a substantial psychological impact on patients. Due to irregularities in the size and shape of their breasts, patients might lack confidence or be ashamed of the appearance of his/ her breasts. This is very similar to the psychological impact experienced by patients who face other cosmetic issues.

Treatment—cosmetic surgery

Patients with tubular breasts can modify the appearance of their breasts with the help of modern-day healthcare and technological advances. Cosmetic surgery in the form of breast augmentation is currently the only treatment option to correct tubular breasts, and it is an invasive procedure.

Cosmetic surgery occurs via either a one or two-step process. The first step is the primary surgery, where a tissue expander or breast implant is surgically implanted into the breasts. The second is a follow-up surgery and typically only occurs if a tissue expander was used in the first surgery. This surgery involves removal of the previously-implanted tissue expander and its replacement with proper breast implants. Overall, the goal of the surgery is to enhance the breasts, making them look fuller and take on a regular shape. In addition, patients might opt to alter their nipples via the cosmetic surgery, to make them look more regular.

Previous research has found that treatment of tubular breasts via cosmetic surgery can have a tremendous effect on patients. Even without perfect reconstruction of the breasts, patients were found to be happier and more confident with their appearance.

Treatment—counselling

Apart from cosmetic surgery, patients may undergo counselling to accept the appearance of their breasts. Though this intervention cannot physically correct the appearance of the patient’s breasts, it can help to alleviate the psychological symptoms associated with the condition and improve the patient’s overall well-being.

Ultimately, patients should check with their doctors if they have queries or worries regarding this condition.