Comparison of clinical and instrumental characteristics in patients with type I–II tubular breast deformity and hypomastia

Purpose of a study: to conduct a comparative analysis of the clinical and instrumental characteristics of breast tissue in patients with type I–II tubular breast deformity and hypomastia for the morphofunctional justification of the choice of the prepectoral subfascial plane of implant placement. Material and methods . A prospective cohort study included 116 patients: 47 women with tubular breast deformity and 69 – with hypomastia without signs of constriction. Tissue condition was assessed using a pinch test, ultrasound, elastography, and a visual echogenicity scale. The thickness of the integumentary tissues of the mammary glands and pectoralis major was measured, and the echogenicity and stiffness of the soft tissues were determined. Results . Patients with tubular breast deformity demonstrated significantly greater soft-tissue thickness (9.1 ± 1.8 vs 5.3 ± 1.5 mm in hypomastia, p < 0.001), higher echogenicity (4.3 ± 0.7 vs 2.8 ± 0.5 points, p < 0.001), increased tissue stiffness by shear wave elastography (66.4 ± 9.2 kPa vs 39.7 ± 6.8 kPa, p < 0.001), and a higher strain ratio (2.9 ± 0.4 vs 1.7 ± 0.3, p < 0.001). The pectoralis major muscle was also significantly thicker, indicating compensatory hypertrophy. Conclusion . The morphofunctional features observed in type I–II tubular breast deformity confirm the structural adequacy of the upper-pole soft-tissue envelope and support the feasibility of creating a prepectoral subfascial pocket without muscle involvement. This approach minimizes the risk of animation deformities, upper-pole overcorrection, and postoperative pain, while ensuring a more physiological and predictable aesthetic outcome.