Tuberous mammoplasty aims to four specific goals, which are addressing the areolar issues, the glandular misshaping, the inframammary crease malpositioning and the underdevelopment or absence of the entire lower pole of the breast.
The areolar herniation and oversizing is treated by intra or extra areolar skin resection and layered suturing supported by a round block thread.
The misshapen tubular gland requires any of the existing techniques for its shape shifting, like Rees and Aston's, Ribeiro's, Puckett's, Palacín's, Mandrekas' and Nogueira's; they all entails certain plasties, cuts, decompressions and redistributions on the breast tissue.
The inframammary crease can be lowered with ease by means of internal pocket access.
The hypoplastic or nonexistent lower pole is reconstructed by means of inserting a suitably sized and shaped breast implant which provides the fullness and skin expansion required.
Tuberous mammoplasty procedures highly require a surgeon featuring top class training, skills and experience on tuberous breasts management.
Such important tuberous mammoplasty is not feasible through approaches to the breast pocket other than areolar incisions, that is the reason why the latter is the mandatory access in these cases.