A Systematic Review of Outcomes and Complications of Tuberous Breast Surgery

Background: Tuberous breast is a complex congenital breast anomaly that can be challenging to correct surgically. Objectives: The authors conducted a systematic review with pooled analysis of data, with the aim of determining the effectiveness and complications related to operative management of the deformity. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were adopted in performing this systematic review. A simplified classification system for tuberous breast deformity was developed to accurately compare data and guide analysis. Results: The review identified 38 studies, reporting a total of 897 patients undergoing tuberous breast surgery. The mean age of patients was 24 years (range 13-53 years). Mean follow-up was 39 months. A combination of tissue rearrangement and implant augmentation was the most common technique (73% of patients) followed by fat transfer alone (9%). Breast implants were employed in 83% of patients. The mean implanted volume per breast was 263 cc. Fat grafting was performed in 13% of patients and mean volume of fat grafted per breast was 185 cc. An overall complication rate of 20% was reported. Subjective assessment of patient satisfaction was 99%, and the mean score on BREAST-Q for satisfaction with clinical outcome was 86.7. Future studies should focus on robust study designs including randomized and cohort studies, use of patient-reported outcome measures, and long-term follow-up. Conclusions: The surgical techniques to correct tuberous breast deformity are safe, effective, and have a high satisfaction rate. Fat transfer has the capacity to provide promising results in treating tuberous breast deformity.