AESTHETIC MEDICINE AND SURGERY
BREAST ASYMMETRY SURGERY
Breast asymmetry surgery
Breast asymmetry, a difference of breast size and shape, is a common condition in women. It may stem from many factors: genetics, hormones, past medical history.
When the difference is significant, one may opt for surgical correction. Undoubtedly, in breast plastic surgery, correction of asymmetry represents one of the most complicated operations. Therefore, a thorough preoperative evaluation is crucial both for the surgeon, to ascertain the causes of the asymmetry, and the patient to fully understand the expected results; an appropriate surgical technique is selected for each individual case.
In case of volume asymmetry, breasts differing in size but with adequate and similar shape, there are two main options: augmentation of the smaller breast or reduction of the bigger breast. This decision is determined by the condition: it is advisable to augment the smaller breast if the size of the bigger breast is in proportion with the body frame and satisfies the patient’s wishes. Alternatively, it is advisable to reduce the bigger breast, if the smaller breast has the desired volume.
In case of breast enhancement, surgery is a unilateral breast augmentation (one breast only). In case of breast reduction, the surgery is a unilateral breast reduction (one breast only). Correction of this kind may also involve both breasts at the same time, i.e. both breasts may be augmented using different size implants (bigger in the smaller breast and vice versa). Equally, both breasts may be reduced so as to obtain similar dimensions (major reduction of the bigger breast and minor reduction of the smaller breast).
If breast asymmetry is due to different shape with adequate and similar volume, correction is often more complicated. The reasons why a breast may appear different in shape from the other are manifold. For example, a frequent cause is a malformation which becomes evident during puberty, when one or both breasts acquire different tubular shapes that range from minor differences to the most severe cases as “tuberous breasts”. Correction of this malformation requires surgical remodelling, in order to expand the breast lower pole, typically hypotrophic (less developed).
Another reason for breast shape asymmetry is different ptosis (descent) of the two breasts. In these cases a mastopexy (breast uplift) is prescribed. This surgery may involve one breast only, if the contralateral breast (opposite side) is in the correct position, or both breasts if necessary: a bilateral uplift.
Breast asymmetry is often due to a combination of many aesthetic irregularities, which may be present for one breast or in both, in various degrees. In fact, it is often necessary to use a range of complementary techniques such as breast augmentation, breast reduction, glandular moulding and mastopexy to achieve optimal symmetry within the same operation. For example, in a case of shape and volume asymmetry, with a bigger and lower right breast and a smaller and tubular left breast, correction may require combined breast reduction and mastopexy on the right side, and breast augmentation with glandular molding on the left.
Note that correction of breast asymmetry may lead to different scars in the two breasts, as a result of different techniques being employed for the specific defects. In any case, whatever the defect and chosen technique, the most inconspicuous scars are achieved by design, residing in hidden areas.