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Breast Tissue Atrophy / Chest Wall Deformity

 

 

The pressure of the breast implant may cause breast tissue thinning (with increased implant visibility and palpability) and chest wall deformity. This can occur while implants are still in place or following implant removal without replacement. Either of these conditions may result in additional surgeries and / or unacceptable dimpling or puckering of the breast.
 
Patients who elect to have large breast implants can sometimes suffer the consequences of having these larger devices with the following problems:

  • ptosis (sagging)

  • tissue stretching

  • tissue thinning

  • inadequate soft tissue cover

  • subcutaneous tissue atrophy
     

 

 

 

The most frequent deformity seen however; is the one from prior breast surgeries.  Capsular Contracture and improper placement of implants are the two complications contributing to the greatest amount of patients requiring surgery again.

Breast Deformities create:

  • Size differences

  • Shape differences

  • Scarring related to implants or prior surgeries
     
     

 

 

Breast deformities can happen because of a surgical procedure or they can be developmental. Developmental deformities which present themselves as birth defects such as Poland’s Syndrome; which shows poor development of the chest muscles reflecting in poor or absent development of the breast.

These deformities in the breast are called “Tubular breasts” because of the shape that they resemble. The breast shape is elongated and thin with a narrow base. It frequently has an enlarged, dome-shaped areola. 

Most recently, surgeons have referred to this deformity as “Constricted Breasts”.

Tubular breasts are hypo-plastic, which means that their development was stunted shortly after the development in puberty. Tubular breasts usually do not contain enough glandular tissue so women who suffer from this condition frequently will have breastfeeding problems, and will more than likely need to supplement their infants’ nourishment with formula.

 

The tubular breast has many variations, but all share certain common features:

  • Small breasts located under an enlarged nipple and areola

  • High and narrow inframammary fold

  • An abnormally narrow breast tissue base

  • An abnormally wide areola with a central protrusion of the breast tissue through the areola.

  • The nipples tend to be very plump.

  • Often the breast tissue cascades falling over the tight fold, and producing significant sagging and shape distortion.


 
 

 

 

 

Breast Implants have been used in a variety of developmental conditions:

 

 

Poland Syndrome is a rare birth defect characterized by underdevelopment or absence of the chest muscle (pectoralis) on one side of the body and webbing of the fingers on the same side.  The incidence of Poland Syndrome is approximately one in 32,000 live births, and its occurrence is almost always sporadic, congenital disease with a low reoccurrence in the same family.  It is three times more common in males than in females. Typically 75% of all cases of Poland Syndrome involve the right side of the patient.  Breast asymmetry is seen with most patients who have Poland Syndrome, along with rib torsion, rib rotation, or a sunken chest.

 

 

 

                                                  Poland Syndrome - Chest Wall Deformities

 

                                     Copyright 2008 Nucleus Medical Art, Inc. - Used with permission

 


 

Pectus Excavatum or commonly referred to as PE is known as a funnel breast or hollowed breast and is a deformity of the front of the chest wall with depressed breastbone (sternum) and ribs. This deformity makes the sternum (breast bone) which is abnormally depressed or caved inward. Pectus Excavatum is the most common congenital chest wall deformity.  Pectus Excavatum is present birth generally or arises shortly thereafter.  It is often progressive; with the depth of the concave sternum increasing as the patient grows. The male to female ratio for this deformity is 3:1. 

 

                                                  Pectus Excavatum - Chest Wall Deformities  

                                           Copyright 2008 Nucleus Medical Art, Inc. - Used with permission

 

 

 
 

Pectus Carinatum or commonly referred to as PC is known as “pigeon breast”, chicken breast, or keeled chest. There is a flattening of the chest wall on either side with forward projection of sternum that gives a bowed out appearance. PC is the second most common congenital deformity of the chest wall and constitutes approximately seven percent of all anterior chest wall deformities. This deformity is more common in males than females with the ratio being 4:1. This deformity is apparent at birth and tends to worsen as the child grows.

 

                                                   Pectus Carinatum - Chest Wall Deformities

                                      Copyright 2008 Nucleus Medical Art, Inc. - Used with permission

 

 

 

 

 

Scoliosis is associated with the axial torsion of the rib cage and is manifested by one chest wall projecting more than the other. Scoliosis always has breast asymmetry giving the illusion that one breast is larger than the other side. This deformity is an abnormal curvature of the spine that usually shows up during adolescence. In most people the curvature is so mild that no treatment is needed.  Pre-operative asymmetry is dependent on many things – mainly the most important factor, the presence and nature of asymmetry pre op.  With the presence of Scoliosis, it is common to have asymmetry to the breast which is related to the size, dimension, chest wall degree (the way your ribs and muscles form), and the location of laxity or sagging and position of the nipple/areola complex. 

 

                                                  Scoliosis

 

                                          Copyright 2008 Nucleus Medical Art, Inc. - Used with permission

 

 

 

 

 

 

 

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