18-year-old female patient shows correcting breast asymmetry with left breast mound void that was 80% smaller than the right breast.
Introduction: Correcting Breast Asymmetry
Correcting breast asymmetry must consider both shape and size differences between the two breast mounds. Asymmetry may involve several variables that may include the nipple and areola complex as well as the breast mound. Correcting breast asymmetry requires a definite plan that takes into account all of the accounted breast mound and nipple changes.
Nipple and Areola Complex Asymmetry
The nipple and areola complex may vary in size and shape as well as position. Often one nipple and areola may demonstrate moderate to severe sagging while the opposite nipple and areola are not sagging at all. Moreover, one breast may demonstrate a herniated areola complex that is enlarged in comparison to the other areola. Correcting nipple areola asymmetry is critical to correcting breast asymmetry.
The herniated areola is most often associated with the smaller breast that is underdeveloped during its embryologic phase with the resulting contraction of breast tissues. Since the breast tissues a tight, the growing glandular tissue will push out and herniate the areola.
Breast Mound Asymmetry
The asymmetry of the breast mound is characterized by variable size, shape, and position. Often one breast mound will develop more generously than the other breast. The more developed breast mound will typically be larger and saggier in appearance. This is in contrast to the less developed breast which often demonstrates no sagging at all.
Interestingly, breast size variability can be quite dramatic between the two breasts. Correcting breast asymmetry typically requires a customized surgical plan that is dictated by the physical asymmetry demonstrated.
Correcting Breast Asymmetry
Correcting breast asymmetry requires a combination of variable breast implant size use to correct size discrepancies and simultaneous breast lift to correct nipple and areola position and size asymmetry. The breast lift will allow for the lifting of the nipple and areola complexes to a more desirable and optimized position. The new implant position is determined by the choice of implant. This is because the implant must be centered on the new implant position.
This is why consideration of breast mound size variability is so important since the new nipple position will be dictated by the implant size and style chosen to correct breast mound size discrepancy. This is because the inframammary crease to nipple distance must equal the radius of the new implant.
Typically, the difference in implant size chosen is minimal between the two sides, because most of the lower breast pole asymmetry can be corrected with wedge excisions employed during the breast lift.
When the chest is viewed it becomes apparent that most asymmetry is in fact over the lower breast pole and with minimal asymmetry over the upper breast pole. Asymmetries over the upper breast pole typically result from chest width variability that can be corrected using variable breast implant styles.
In correcting breast asymmetry, implant style differences, such as low, moderate, and high profiles, can provide your surgeon the variety in shape needed to correct breast mound asymmetry. For example, variable sizes in implants may preserve identical implant radius while making sure that the breast volume discrepancies are corrected. As such, differences in projection can be corrected without creating different breast widths and upper pole fullness.