Management of Tuberous Breasts by Exclusive Fat Grafting.

[INTRODUCTION] Tuberous breast is a congenital breast deformity that can have a significant impact. Most therapeutic algorithms involve glandular remodeling, with or without the addition of a breast implant. The increased use of fat grafting in breast surgery has introduced a new tool in the surgical arsenal. We conducted a retrospective study. The primary objective was to evaluate our surgical technique. The secondary objective was to assess patient satisfaction in a larger cohort than previously studied.

[MATERIALS AND METHODS] This retrospective study included patients operated for unilateral or bilateral breast deformities. The fat grafting technique was offered to patients without any personal or familial history of breast cancer and with a mammogram performed within six months rated ACR 1 or 2. Patient satisfaction was retrospectively assessed at a minimum of 6 months post-op using the Breast-Q® augmentation module and an analog scale rated from 1 to 4.

[RESULTS AND DISCUSSION] Statistical analysis was conducted on the 81 patients (103 breasts) included in the study. The median was two interventions. The only complication found was cystic fat necrosis cysts in 3% of breasts (n=3), with only one requiring surgical fragmentation. Patient evaluation was not correlated with the stage of the tuberous breast. According to our satisfaction scale, 90.9% of patients were satisfied or very satisfied with the overall appearance of their breasts.

[CONCLUSION] Fat grafting should not be considered merely as a volume augmentation but as a true reactivation of breast growth, akin to a localized pubertal restart of an underdeveloped breast. The quality of results obtained, the very high level of patient satisfaction, the very low complication rate, and the definitive nature of the reconstruction have made this technique our Gold Standard for managing tuberous breasts.

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