Breast malformation correction in Thessaloniki and Athens, Greece

Breast malformations are problems in how the breasts develop, either before birth or during puberty, in one breast or both. The main types are tuberous breast, Poland syndrome, marked asymmetry and inverted nipples. Correction may be done for aesthetic reasons, medical reasons or both, and the right approach depends on which malformation you have.

An inverted nipple can make breastfeeding difficult and lead to inflammation. Poland syndrome can affect the chest muscle and the front wall of the armpit.

Treatment depends on the type of malformation. An inverted nipple can often be corrected with a minor operation under local anaesthesia, while a tuberous breast or Poland syndrome may need a larger operation or several stages.

Problems that appear after a previous breast operation, such as a double bubble, an implant that has dropped too low (bottoming out) or an implant that sits too high, are not congenital malformations. They are covered on the breast revision surgery page.

Good candidates are healthy adults whose breasts have finished developing and who have a tuberous breast, Poland syndrome, marked asymmetry or an inverted nipple. Severe forms may need more than one operation. Whether correction is right for you, and how it should be planned, is decided when I examine you.

Who typically comes for correction?

• Women with tuberous breasts, even a mild form, who come for breast augmentation without knowing it is a malformation.
• Women with a visible difference in size, shape or nipple height between the two breasts.
• Women and men with Poland syndrome.
• Anyone with an inverted nipple that bothers them aesthetically, makes breastfeeding difficult or causes inflammation.

When do I advise against it?

• Before the breasts have finished developing.
• During pregnancy or breastfeeding, and for the first 6 months afterwards.
• When there is an active infection or an untreated breast condition.
• For a nipple that has recently started to turn inwards on one side, until it has been checked for malignancy.
• In heavy smokers, when the correction includes a reduction or a breast lift, unless they stop smoking 4 weeks before and 4 weeks after.

At the consultation I examine both breasts and explain what can realistically be corrected, with which techniques and in how many operations, and you leave with a written plan. Before surgery you need blood tests and an anaesthetic assessment, and you must stop smoking 4 weeks before and 4 weeks after the operation.

What happens at the consultation?

I examine the shape, size and height of the breasts, the inframammary fold, the nipple, the areola and the quality of the skin and, in Poland syndrome, the chest muscle and the armpit. We discuss what can realistically be corrected, with an implant, fat, a breast lift or a reduction, in one or more operations. If you plan to breastfeed, this is taken into account. You receive a written plan.

What tests do I need before surgery?

You need blood tests, a pre-operative check for the anaesthetic and, where needed, a breast ultrasound. Stop smoking 4 weeks before and 4 weeks after surgery. If you take anticoagulants or antiplatelet medicines, tell me; they are stopped only with the agreement of the doctor who prescribes them.

Most corrections are done under general anaesthesia; an inverted nipple can also be corrected under local anaesthesia. The technique depends on the malformation: an implant, fat transfer, release of the fibrous ring, a breast lift, a reduction or a latissimus dorsi flap. I often combine techniques, and severe forms are corrected in stages. The correction usually takes 1 to 3 hours, longer with a flap.

Each malformation is treated differently. I often combine techniques in the same operation, so that shape, volume and nipple position are corrected together. In severe forms the correction is done in stages.

Tuberous breast

This is one of the most common malformations, in one breast or both. A fibrous ring inside the breast stops the lower pole from developing and, in severe forms, the whole breast. In mild forms the breast is pear-shaped; in severe forms it is tube-shaped, with a swollen nipple that protrudes. Many women who come for breast augmentation have a mild form without knowing it.

In grade one, the lower pole has not developed, the breast is small and the inframammary fold sits higher than normal. Here the solution is an implant, fat transfer or both (see the breast augmentation page). In more severe forms, where the nipple is significantly affected, I release the ring that constricts the breast and redistribute the volume around the nipple, usually through an incision around the areola, combined with an implant, fat or a breast lift.

Poland syndrome

Poland syndrome is incomplete development of the breast, which may also involve the nipple, the pectoralis major muscle or even the upper limb. Depending on the aesthetic and functional deficit, I use the latissimus dorsi muscle as a rotational flap to rebuild the chest muscle and the front wall of the armpit, and a silicone implant for the missing volume.

It rarely affects both sides, and it can also occur in men. In men I use the latissimus dorsi flap or special male silicone implants.

Breast asymmetry

A small difference between the two breasts is normal. When the difference in size, shape or nipple height is large, I correct it with whatever combination is needed: augmentation of the smaller breast, reduction or a lift of the larger one, or fat transfer. For these operations, see also the breast lift and breast reduction pages.

Inverted nipple

With an inverted nipple, the nipple points inwards, usually because of fibrous tissue, on one side or both. Correction is surgical, under local or general anaesthesia. The milk ducts, and with them breastfeeding, are often preserved, but this is not guaranteed. Recurrence is rare.

If a nipple that used to be normal suddenly starts to turn inwards on one side, see a specialist straight away, because it may be a sign of malignancy.

Incisions and stitches

The incision depends on the technique: in the inframammary fold or around the areola for an implant, around the areola for releasing the ring, small incisions of a few millimetres for fat transfer, an incision on the back for the latissimus dorsi flap, and the breast lift or reduction incisions where these are needed. For an inverted nipple the incision is small, at the base of the nipple. The stitches are internal.

Hospital stay

In most cases no overnight stay is needed and you go home the same day, with someone to accompany you. You must not drive after a general anaesthetic. Correction of Poland syndrome with a flap may need an overnight stay.

Recovery depends on the operation and usually takes 2 to 3 weeks. After inverted nipple correction you are back to daily life almost immediately. With an implant, fat or a breast lift, recovery follows that of those operations, while a latissimus dorsi flap for Poland syndrome takes longer.

How long you stay depends on the operation. Most corrections need no overnight stay, so you leave the hospital the same day; a latissimus dorsi flap for Poland syndrome may need one night in hospital. Plan to stay in Greece for 5 to 10 days before flying home.

Inverted nipple correction is a minor operation, often under local anaesthesia, and needs the shortest stay, from day 5. After an implant, fat transfer, a breast lift or a reduction, allow 5 to 10 days. After a flap for Poland syndrome, you can usually fly from about day 10.

The stitches are internal and absorbable, so nothing needs to be removed. I see you for a final check the day before your flight.

Follow-up once you are home: by video call at 10 days, 1 month, 6 months and 1 year, all done by me.

At home, arrange:

• someone to accompany you on the day of surgery, as you must not drive after a general anaesthetic;
• time off work, usually 1 to 3 days after nipple correction and 5 to 7 days after an implant, fat or a lift, with no heavy lifting in the first weeks;
• a support bra where needed;
• a gradual return to exercise from week 6, especially after an implant or a flap.

Symmetry is assessed at 3 to 6 months. If a second operation or a repeat fat transfer is needed, it is done after 6 months, which means a second trip.

In most cases the result is permanent, with a more natural shape and better symmetry. Mild forms usually need one operation; severe forms may need a second for refinement. Perfect symmetry does not exist even in breasts that developed normally, so the aim is a result that suits your body.

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Breast malformations

Woman, 25 · 12 months after

Results vary from patient to patient.

Inverted nipple correction is permanent, with very few recurrences. Where an implant is used, the same applies as in breast augmentation: implants are very durable but not lifelong. Fat survival cannot be predicted, so a repeat session may be needed. A new pregnancy or a large change in weight can alter shape and symmetry. If a problem arises with an implant from a previous operation, see the breast revision surgery page.

The risks depend on the technique and are the same as those of breast augmentation, a breast lift, a reduction or fat transfer, and of the flap in Poland syndrome. Most are rare and can be treated. In severe malformations a second operation may be needed for better symmetry. I explain the risks for your own case at the consultation.

Smoking. Stop at least 4 weeks before and 4 weeks after surgery: smoking increases healing complications and reduces the success of fat transfer. When the correction includes a reduction or a breast lift, I do not operate on heavy smokers unless they stop 4 weeks before and 4 weeks after.

Blood thinners. Tell me if you take anticoagulants or antiplatelet medicines. They are always stopped in agreement with the doctor who prescribes them.

I do not publish prices, because the cost varies widely with the malformation and the operation it needs, from a minor nipple correction under local anaesthesia to an operation with an implant, fat or a flap. You receive a quote after the consultation, once I have examined you and we have agreed on the plan together.

• The malformation and its severity.
• The technique: implant, fat transfer, breast lift, reduction or flap.
• Whether one or both breasts are corrected.
• The anaesthesia, general or local.
• The type of implant, where one is needed.
• Whether the correction is done in one operation or several.