What is Breast Asymmetry?
It is unusual to measure a patient to determine their implant options and get identical measurements on both sides. Some degree of asymmetry is normal; perfect symmetry is rare. Most differences do not require any special attention since often the patient was not even aware. However, when there is a significant and visible difference, correction can be very rewarding.
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Positional asymmetry
In some patients one breast sits visibly higher on the chest wall, more often the left. This can result in the implant sitting higher too since the ideal pocket exactly follows the pre existing breast fold and serves as the “shelf” on which the implant rests in the body. There are techniques such as biplanar pocket formation which allow the lower pole to expand better and the implant to sit lower on that side for a better match. Sometimes with a very highly defined breast fold with tissue hanging below the fold (“descent” of the lower pole), attempts to lower the implant below the fold can lead to a double bubble deformity. In these cases it is often best to accept some differences in breast position and try different sizers during surgery to get the best match along the upper breast, the part seen in outfits. Most patients enthusiastically agree that it’s better to have a slight visible difference when the breasts are completely exposed than one which is always apparent even in outfits. Intraoperative sizing involves using temporary implants to get the best match during surgery (remember silicone gel implants are prefilled and not adjustable). Once the ideal sizes are determined, the temporary ones are replaced with your new, permanent implants, often of slightly different size.
Nipple areolar asymmetry can be improved in many cases with a vertical repositioning of the lower nipple using a crescent mastopexy. This leaves a very fine scar along the border of the upper half of the areola and can usually move the position up as much as 1 cm. More extensive mastopexy procedures can move the position to any position desired.
Nipple Areolar Asymmetry Before & After
Patient Testimonial
"I highly recommend Rachel Walker, MD and Paul Kraft Day who is a member of her team. They both treat you with the greatest respect and care, no matter what the reason for your visit. Unlike many medical environments you do not feel like they are rushing you through your visit. They take time to carefully explain what is happening and make sure there are no misunderstandings or outstanding concerns."
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Size asymmetry
As with positional asymmetry, breasts of significantly different size can be greatly improved with the use of intraoperative sizers, trying different prefilled silicone gel implants until the best match is achieved. Since breasts of different size frequently have shape differences too, often the best possible result is a great improvement but may not be perfect. It’s very important to have realistic expectations set before surgery and we use a very extensive collection of before and after pictures to demonstrate realistic outcomes. Corrective breast surgery may involve creative reshaping of the breast with a variety of mastopexy and pocket sculpting techniques in addition to differently shaped implants, making these challenging and interesting for the surgeon. This is a special passion of mine and we have a tremendous number of pictures showing almost every variable imaginable!
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Candidates for breast asymmetry correction in Dallas, TX
A good candidate would be a woman who feels self-conscious about the unevenness in her breasts. Although it’s virtually unheard of for a woman’s breasts to be perfectly symmetrical, sometimes the variance can be enough to be overly noticeable. This can be due to breasts not growing at the same pace during puberty or from simple idiosyncrasies in anatomy.
But if a woman feels her uneven breasts are overly visible, they are likely to make her self-conscious. She would be a good candidate for breast asymmetry correction surgery in Dallas, TX with Dr. Walker. Of course, a good candidate also needs to have realistic expectations and be healthy enough for surgery.
What if you want to augment both of your breasts, but one is larger than the other?
Dr. Walker can use different techniques to increase and equalize the breasts in these situations. Breasts of different sizes often have differences in shape, so there often remains some difference between the two breasts. Dr. Walker can reshape the breast tissue, and she can compare various prefilled silicone implant sizes to augment the breasts to the size where they are roughly the same. If the patient has sagging skin, a breast lift combined with implant placement is often the best way to remove or dramatically reduce the difference between the breasts.
Can I have fat grafting for breast asymmetry correction?
Dr. Walker often uses fat grafting as a subtle method for increasing the size of one or both breasts to attain symmetry. Taking unwanted fat from an area such as the flanks, purifying it, and then injecting it into the breasts is a great option because the procedure is basically two procedures in one. You lose the fat from where it is unwanted through liposuction, and then it is used to naturally augment the breasts.
Fat grafting can be a successful option for these procedures because, unlike implants, grafting can be used in more specific, smaller areas to change the shape and size of the breasts. This is effective when the breasts are close in size, yet obviously asymmetrical.
How is breast asymmetry corrected?
As mentioned above, Dr. Walker uses different methods when correcting asymmetry. She will use these procedures to fit the situation:
- Breast augmentation with implants — A breast prosthesis or implant may be inserted below one or both breasts, and the implant volume is then adjusted. The use of implants is effective if the breasts are dramatically different in size.
- Breast augmentation with fat transfer — Fat transfer can be used to increase the size of one or both breasts. Unlike implants, the fat can be injected into deficient sections or areas of the breasts to change the contour and shape. Fat transfer is best for patients who don’t have a large difference in size between the breasts.
- Breast reduction — In many cases, the woman is happy with the volume and shape of her smaller breast, so she wants to reduce the asymmetry by having reduction surgery to downsize the larger breast. Reduction surgery is akin to a breast lift, but it removes breast mass in addition to sagging, excess skin. The end result will be breasts that are symmetrical, smaller, and higher on the chest. Liposuction may be included to remove excess fatty tissue.
- Breast lift — When the breasts are even in size, but one breast is positioned lower than the other, a breast lift is an effective option. In a breast lift Dr. Walker removes excess, sagging skin and repositions breast tissue to bring more of the breast mass back to a higher position on the chest. This firms and elevates the breasts. With asymmetry, it’s likely both breasts will be addressed so that they can have similar appearance after the lower breast has been elevated.
- A combination — Dr. Walker sees every case of breast asymmetry as unique. She may feel the best solution is a combination of these techniques in a single surgery. For instance, if one breast is larger than the other plus it has descended with time and possible pregnancy and breastfeeding, it’s likely that the size will need to be changed (whether larger or smaller) and a lift will probably be part of the process as well.
How visible will my scars be after asymmetry correction?
Scarring depends on the technique Dr. Walker uses. The most scarring occurs with breast reduction using the anchor incision. This incision circles the areola, runs downward to the breast crease, and moves outward in both directions. This is necessary to remove the most excess fatty tissue and sagging skin. When the need isn’t as great, Dr. Walker may only need smaller incisions.
If breasts can be equalized with implants placed through an incision at the base of the areola, these incisions are virtually invisible after healing. Also, placement of saline implants requires a much smaller incision than silicone because they are filled once in place. Silicone implants are prefilled.
The only process that doesn’t create any scarring on the breasts is fat transfer.
How will I know which type of procedure is what I need for my asymmetry?
This isn’t something you need to worry about. During your consultation with Dr. Walker, the two of you will discuss your goals and changes you’d like to see with your breasts. She will then examine your breasts to generate a plan to achieve your goals. She’ll discuss with you the methods she thinks could work, and the two of you will walk through the process.
Dr. Walker also has the Vectra 3D system to create virtual changes based off photos of your body. This amazing software allows you to see how different techniques or methods can look on your body.
Schedule a client consultation
If you are interested in learning more about breast asymmetry correction surgery in Dallas, TX, contact our office at (972) 661-5077 to schedule a consultation today! Our practice proudly serves the Dallas, Fresno, & Plano, TX areas.
