Abstract
Tuberous breast deformity was first documented by Rees and Aston in 1976. The deformity is well documented in cisgender women, with rare cases in cisgender men often associated with gynecomastia, and almost no reports in transgender women. Herein, we present a case of a 32-year-old transgender woman who developed bilateral tuberous breast deformity after 10 years of hormone replacement therapy. This report highlights the rarity of the condition in transgender women, discusses its clinical presentation, and its surgical management. Given the growing number of transgender individuals undergoing gender-affirming care, recognizing and addressing such anatomical variations is crucial for optimizing surgical outcomes.