The tuberous breast deformity is one of the most challenging congenital breast anomalies. The nomenclature, classification, and treatment of this pathological condition have varied considerably. In this study, 16 patients with 23 tuberous breast deformities are evaluated. The breast deformities are classified according to the three-tier classification system used at the authors' institution. The treatment pattern is evaluated and a flexible algorithm is discussed for the treatment of the tuberous breast deformity.