Tuberous breast: revised classification and a new hypothesis for its development

Area of Science:

• Plastic Surgery
• Anatomy
• Endocrinology

Background:

• The Grolleau classification for tuberous breasts does not encompass minor forms like isolated nipple-areola protrusion.
• Tuberous breast deformity is characterized by a congenital dermal weakness of the nipple-areola complex (NAC).

Observation:

• Six patients with normal breast shape and ten with hypertrophic breasts presented with isolated nipple-areola protrusion.
• Hormonal influences during the prepubertal period may contribute to breast development and deformity.

Findings:

• Isolated nipple-areola protrusion represents a minor, previously unclassified form of tuberous breast deformity.
• This finding supports the concept of tuberous breast deformities as a spectrum of a single entity.
• A new type (Type 0) is proposed for isolated simple areola protrusion, either permanent or intermittent.

Implications:

• The revised classification and proposed hypothesis enhance the assessment of breast morphologic anomalies.
• A perinipple surgical approach effectively corrected isolated herniated NAC with minimal scarring.
• Understanding the spectrum of tuberous breast deformities aids in surgical planning and patient counseling.