Many parts of our body are asymmetrical. Breast asymmetry is particularly common so no wonder that many women are aware of a slight difference in the shape and/or size between two sides. In most cases this is mild and no intervention is required at all. More noticeable differences (for example, at least one bra cup size discrepancy) or completely different shapes between two breasts often justify corrective surgery. Some examples are illustrated to the right.
Condition is almost always entirely benign and predominantly of cosmetic and psychological concerns. Surgical correction of breast asymmetry has shown to have immensely positive impact on women’s wellbeing, confidence and self-esteem. It is often carried out following breast cancer treatment.
It is almost impossible to find even two similar patients. Clinical presentations are highly variable (as illustrated) and so are the surgical options and reconstructive combinations. Sometimes only one side can be treated to achieve more balanced look; other times both sides have to be addressed. Operations are planned as per patient preferences and roughly guided by basic surgical principles. The commonest options are:
Breast Enlargement (augmentation):
Performed on the smaller breast, increasing its tissue size and making it similar to the other.
Can be performed to reduce the larger of the two breasts to match the smaller breast.
Breast Uplift (mastopexy):
Often accompanies the above two procedures – it raises the nipple to the higher position and tightens the glandular tissues within the breast improving shape and projection of the breast rather than changing the volume and size.
This is a safe and elegant technique whereby a temporary, inflatable implant is inserted on the smaller side first. Volume of the expander is gradually increased by injecting the saline through a tiny valve and tube connected with an implant. This is done in outpatient’s room. Expander will stretch the soft tissues and is left in for about a year or so. Once breast is expanded to the desired volume, the second operation is performed when the temporary expander is exchanged for the permanent silicone implant of the corresponding size. This method has the advantage that an accurate size match between the two breasts can often be achieved. The silicone implant that replaces the saline expander has a softer, more natural feel, which is why many women choose to have the expander replaced. Alternatively, the valve can be removed and the expander can be left in place, acting as a permanent implant, without having to be replaced.
The decision on which procedure to undergo to correct breast asymmetry is something that needs to be carefully discussed at the time of your consultation. Deciding to balance the size or shape of your breasts is a very personal matter, and ultimately only you can decide if it is right for you. My role is to assist your decision, guide you through various options and explain what is realistically possible against your preferences.
Stable results are common in adult women whose breasts are no longer growing. In younger ladies whose breast are still enlarging, postoperative changes are likely and it should be clear that additional adjustments might be likely in the future and are often an integral part of staged treatment. In many cases, it is not possible to achieve absolute symmetry between two sides, but major improvements are possible and often a norm. The aim of surgery is improvement rather than perfection!
This page provides only basic and generic information. Full details and explanations are provided at the consultation as no two patients are the same and personal circumstances are highly individual. During the consultation patients will be provided with a detailed leaflet and comprehensive informed consent on risks and complications associated with this operation, few of which are mentioned above.