Breast asymmetry is a very common concern. It can become apparent in adolescent girls and adult women. Breast asymmetry affects more than half of all women. It can cause many challenges including self-consciousness in intimate settings or when wearing revealing attire such as a bathing suit or evening gown. Affected women may have difficulty even getting day to day clothing and intimate apparel to fit properly. When the difference in breast size is greater than one bra cup, affected girls and women may experience psychological distress. In severe cases, breast asymmetry can be truly disfiguring.
No one really knows what causes breasts to develop differently from one another, but possible contributors include
- Hormonal changes or traumatic injuries.
- An underlying medical or skeletal condition such as juvenile, or virginal, hypertrophy of the breast: a very rare problem in which one breast grows significantly larger than the other. Poland’s Syndrome is another possibility. It is characterized by the deficiency or absence of the pectoralis major muscle; however, the ribs, sternum, breast and nipple can also be deficient. It is typically treated with surgery.
- Sometimes, underlying fibroids-non-cancerous tumors may be the cause of asymmetry. Sudden or recent differences in breast size due to underlying breast masses should be evaluated by a breast surgeon.
- Other possible causes include scoliosis, or curvature of the spine, and deformities in the chest wall.
Some research suggests that breast asymmetry may be a marker for women who have an increased risk of breast cancer. Generally, however, slight differences in a woman’s breasts are of no concern. Asymmetry can be measured via mammogram or a special type of three-dimensional laser scanning called SCAN-3D.
The first step in correcting breast asymmetry is to determine the ideal size breast for you. Dr. Sabry will evaluate you and provide you with his frank and expert assessment of your best options. Sometimes the smaller breast needs to be made bigger with an implant or your own harvested fat; sometimes the larger breast should be reduced. Dr. Sabry will thoroughly evaluate your specific anatomy, make specific recommendations, and work closely with you prior to surgery to ensure that you understand both what to expect and what the outcome of your procedure will be. If you are a smoker, you will be asked to quit smoking for 6-8 weeks prior to your procedure. Once you decide to move forward you will meet with our Practice Manager to go over scheduling, payment options and insurance questions.
As you approach your surgery you will have a comprehensive preoperative visit in our office approximately two weeks before your breast surgery. A complete list of “dos and don’ts” will be reviewed as well as the pre and postoperative instructions and any questions that remain. You will be directed to avoid anything that has a blood-thinning effect (aspirin, ibuprofen, etc.) for two weeks before surgery. Basic blood work for preoperative testing will be ordered, and any breast imaging studies that are required (age and past medical history appropriate) will be obtained.
The best results and most recommended approach is when the same thing is done in both breasts. If the breasts are very large, both may be reduced, but one is reduced more than the other. If the breasts are small, both may be augmented, but one is augmented more than the other. In severely asymmetric cases, one may be reduced and the other augmented. It is important to keep the breasts as much “the same” as possible, so each final breast looks and feels as much the same as possible, and has roughly the same amount of breast tissue and fat or implant volume.
Whether you are augmenting or reducing breast size, your surgery will be performed through a small incision in the lower breast, usually at the bottom edge of the areola. This allows Dr. Sabry access to either remove excess breast tissue, or to shift the breast tissue to a different position in order to augment with fat or an implant.
Breast augmentation may be performed with an axillary, peri-areolar or infra-mammry crease incision. Augmentation which requires an implant may be performed via peri-areola or lollypop incisions. If a breast is augmented with fat grafting alone, there will only be very small 3-4 mm incisions (barely noticeable) for the introduction of fat grafts. Reduction on a larger breast may be performed with either the lollypop or inverted T scar, depending on the size of the breast and best outcome potential to minimize visible scarring.
Often with breast asymmetry, one or both breasts are “constricted” in the lower pole, a condition known as “tuberous breast deformity”. In this scenario, a peri-areolar approach is ideal to release the tethered breast tissue and introduce an implant. This incision also allows the breast to “unroll” so that it extends to the correct position, rounds the breast tissue out and raises the nipple position. At this point if needed, Dr. Sabry will adjust the nipple height or areola width for symmetry.
You will go home in a comfortable surgery bra with adjustable straps. Most patients feel tired and sore after surgery, but this is easily managed with medication and usually passes in a day or two. Many patients return to work within the week. Any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Augmented breasts will reach their final shape in two to three months. Dr. Sabry will see you for post-operative visits during your recovery. He and our staff will answer any questions you may have about your recovery, as well as your overall health and well-being.
We schedule regular monitoring of breast implants after breast augmentation to ensure continuing breast and implant health. Standard follow-up visits are at one week, six weeks, and 12 months
Complications following breast surgery are uncommon and usually minimal. Under Dr. Sabry’s expert and meticulous care all measures are taken to minimize the potential. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, asymmetry, implant migration, unfavorable scarring, and breakage or leakage of the implant (implant rupture) as a result of injury or the normal compression and movement of your breast.
If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. If a silicone implant leaks, you will need to see the doctor for replacement of the implant.