[Tubular Breast Deformity: Presentation of an Established Treatment Algorithm and Results of a Retrospective Study Over 7 Years].

Abstract

Congenital deformities of the female breast pose a unique surgical challenge, requiring an individualized approach, particularly for young patients. In this article, we describe a surgical treatment algorithm evaluated over a 7-year period through a retrospective study, focusing on complication rates and breast anthropometric data.A retrospective cohort study was conducted, including 36 patients followed up for 7±3.2 years. All patients underwent surgery based on the proposed therapeutic algorithm. Postoperative assessments were performed at 1 and 6 weeks and 6 months to 10 years. Clinical data, including complications, Baker grade, ptosis degree, and anthropometric measurements, were collected. Additionally, 3D breast images were taken, and a validated patient-reported quality of life outcome measure (Breast-Q™) was administered.Alloplastic augmentation exhibited a significantly higher complication rate (42%) compared with autologous fat transplantation (7.69%). We observed a mean side-to-side difference in areolar diameter of 0.37 cm for autologous reconstruction and 0.78 cm for alloplastic augmentation. The calculated symmetry index revealed 93% symmetry for both therapeutic approaches. All objective measurement methods demonstrated a lasting, symmetrical therapeutic success in correcting congenital deformities. Long-term patient-reported result satisfaction (Breast-Q™) was 74%. Patients undergoing autologous reconstruction required an average of 2.9 procedures to achieve the desired outcome, compared with 1.3 procedures for alloplastic augmentation.The therapeutic algorithm proved to be valid in terms of complication rates, breast symmetry, nipple-areolar complex (NAC) symmetry, and patient satisfaction. It can be considered for patients with congenital breast deformities. Alloplastic reconstruction should be critically discussed due to its increased complication rate.