Correction of tuberous breasts using the unfolded subareolar gland flap

In this retrospective study, the authors present 12 years of experience using a modified Puckett's technique with a double unfolded strictly subareolar glandular flap for surgical correction of the deformity known as "tuberous breast." In 1976, Rees and Aston documented this congenital malformation of the mammary glands in women. Its cause is unknown, and it affects adolescent girls with varying severity uni- or bilaterally. The condition is characterized by a lack of development, primarily in the lower quadrants of the breast plus a rising of the inframammary fold, together with herniation and increased diameter of the areola. Many varied surgical techniques for correction of this malformation in its different degrees of severity have been documented in the available literature. This study examined the treatment of 42 breasts in 26 patients with a high percentage of full correction of the deformity. The advantages and achievements of the double unfolded strictly subareolar glandular flap include restructuring of the breast's lower pole in volume, length, and shape; reduction and even removal of the double-bubble effect as the flap covers the implant fitted; lowering of inframammary fold height; and correction of areola size and herniation. The procedure is performed through a hemi- or periareolar incision. The technique is versatile for managing the different variations of tuberous breasts, making it another interesting option for correction of the deformity. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .