"TUBEROUS BREAST: A WIDE SPECTRUM OF FEATURES OF THE SAME DISORDER. 13-YEAR EXPERIENCE-BASED CLASSIFICATION AND RECONSTRUCTIVE ALGORITHM".

BACKGROUND: Due to the multitude of variants in which tuberous breast (TB) deformity could appear, a reconstructive algorithm could help to assess all features that affects the breast and, therefore, planning the most appropriate surgical strategy to correct the malformation. Although in the literature several efficient techniques have been successfully described, the authors propose their experience to standardize a diagnostic and therapeutic approach. The aim of this article is to assess the peculiar pathologic hallmarks of each type of deformity and to propose a one-step reconstructive algorithm tailored on the distinctive patients' characteristics, based on the use of three different adipo-glandular flaps.

METHODS: From September 2006 to December 2019, 118 patients have been treated for TB deformity in one-step procedure using tailored local flaps according to the preoperatively assessed clinical variant. Minimum follow-up was 12 months. All the procedures were performed under local anesthesia.

RESULTS: A total of 220 TBs (98 hypoplastic and 122 normoplastic) were treated. Patients' mean age was 20.2 years. Mean follow-up was 36.5 months. 6 minor complications (capsular contracture and nipple-areolar-complex hypoesthesia) and no major complications have been reported. In 9% of cases, minor secondary procedures, including lipofilling, scar revisions and breast implant substitution, have been performed.

CONCLUSIONS: The proposed algorithm, including a comprehensive classification, preoperative planning and surgical approach derived from authors' experience, aims to propose a tailored surgical approach for each type of tuberous breast deformity.