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How do you correct "snoopy dog" deformity of the breast?

Q:

I had breast augmentation a while back.  One of my breasts was constricted.  I have developed tuberous "snoopy dog" deformity in the constricted breast.  I have seen a few doctors to have my snoopy dog breast corrected. Two doctors said that I should have the breast dropped; that way it would correct the implant sitting so high on my chest.  Another doctor that I saw said I would need to have a lift performed on the breast in order to properly correct it and to avoid getting snoopy dog deformity again.  At this point, I am totally confused.  Please advise.

A:

I have treated "snoopy dog" deformities of the breast on numerous occasions.  The problem is usually caused by drooping (ptosis) of the breast and an implant that is sitting too high in the sub-muscular position.  I almost always do a breast lift and re-position the implant at the same time to fully correct this deformity.

This approach has the advantage of giving a very nicely shaped breast and lasting for many years.  The disadvantage is the scar associated with the breast lift.

Steven Robinson, M.D., F A C S

Steven L. Robinson, M.D.
Columbus, OH

A:

This is a difficult  question to answer without any photos or an examination.  There are certainly options with this type of problem.  Dropping implants can lead to other problems such as fold mal-position which is lower than the other side or that falls lower than the other side after time passes.

A:

If the breast was a tuberous breast prior to surgery, then the constricted base of the breast and the breast tissue causing the conical shape need to be released.  In some more severe cases a flap of adjacent tissue may be needed to expand the base sufficiently to correct the constriction and to allow adequate room for a breast implant to be placed.

If a one-sided problem, the tuberous breast is often higher than the other one, and lifting the opposite breast is necessary to achieve good symmetry.

If the breasts became constricted after the implant surgery, then you probably have a significant scar capsule contracture which requires surgical release.

 

Fredrick A. Valauri, M.D. F.A.C.S.M.D., F.A.C.S. - View Other Answers by this Doctor
New York, NY

A:

Very good question and you have every right to be confused. I will give a general answer and you will need to determine what makes sense for you and which plastic surgeon you have the most confidence in.

First, I would assume that you want to match the other breast. So you need to look at the two breasts and determine how they are different.  In the tubular breast, is the implant higher, lower or the same position as the non-tubular one; is the nipple in a higher, lower or same position as the non-tubular one?  Is it a case where the tubular breast is simply sitting on top of a well placed implant or drooping off of the implant?

You can only know how to fix something if you know what the problem is.  Once you have determined what the problem is then you can consider the appropriate treatment.  So, if the implant is in the correct position relative to the "good" breast then it makes sense to work on the breast tissue itself and not the implant.  If the implant position is the problem, then moving it into the correct position should be done.  I suspect that you will still need some actual breast work done even if it is an implant issue because the tubular breast is an abnormal breast and usually needs something done to the breast tissue in order to obtain the best result.

I hope this helps.

John P. Stratis, M.D. - View Other Answers by this Doctor
Harrisburg, PA

A:

This is a difficult question to answer without examining you. A 'Snoopy Breast' deformity generally means that the breast seems to herniate through the nipple areas, to some degree. There are 2 principle correction options:

1) Augmentation to give more volume and correct any asymmetries

2) Skin Re-draping to correct the nipple herniation

Personally, I think the best correction is achieved when we are able to place the implant behind the gland (rather than behind the muscle) and then make any skin corrections after.

Again, a difficult question to answer without examining you.

Montreal, QC

A:

It is difficult to give you much advice without seeing you but in general a tuberous or constricted breast requires additional correction to allow an improvement in appearance with breast augmentation.  In a minor expression of the deformity it may require only some additional release inside, while in the more severe cases a peri-areolar breast lift may be required. It really depends on the shape of your breasts.  I would visit with a plastic surgeon who can show you photos of similar cases and can explain to you what he/she feels is the best way to treat you.

Best of luck,

Dr. Edwards

A:

The first issue is whether or not the breast implants are symmetrical and if they are high.  If the implants are not symmetrical, then they must be made so.

If they are high, then this should be corrected by enlarging the lower part of the pocket by releasing the pectoral muscle if the implants are subpectoral (beneath the muscle); or by enlarging the lower part of the skin pocket if the breast implants are subglandular (above the muscle); and by releasing scar capsule contracture, if one is present.

Once this is done, then the ptosis or drooping must be evaluated.  If it is still present, then a breast lift is needed.  This "snoopy dog" is more common when the implant is in the submuscular position. is high, and the patient has a significant amount of breast tissue.  This results in a mound from the breast tissue below a second mound from the high submuscular breast implant.  This is also called a "double-bubble.

Fredrick A. Valauri, M.D. F.A.C.S.M.D., F.A.C.S. - View Other Answers by this Doctor
New York, NY

A:

A breast lift is usually done to correct a snoopy deformity.  However since you had a tuberous breast, you may need a mastotomy to release the constricting bands in addition to your breast lift.  However if your breast is very constricted and has not been stretched by your breast implants a more complex procedure called soft tissue expansion may be necessary.  Please consult an experienced board certified plastic surgeon.

A:

These are very difficult cases and a photo would really help.  Fortunately, you have an implant in place which have stretched out the lower pole of the breast.  The solution is to reposition the implant if it is too high and a peri-areolar lift to re-position the sagging breast tissue. You can always get a third option as well.  Good luck.

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