Breast asymmetry is best defined as differences in breast size, breast shape, an imbalance between the breasts, difference in the nipple/areola size and height, a variation in inframammary creases (fold at the lower breast) and overall contour differences of the breast. The larger the breast (more volume), the greater often are the differences.
Asymmetry is common in the breast. Very few women consider their breast symmetric, and most of the time, a little asymmetry is no issue. However, when breast shape differs too much, simply wearing a bra and getting it to fit comfortably becomes a challenge. Asymmetry with droop can be more annoying when bras just don’t give the support, look and control you desire.
The breast can develop with asymmetry during puberty and persist through life and asymmetry can gradually occur with weight changes, hormone changes, after pregnancy, and with aging. Becoming more symmetric can make you look better, and more importantly, it can, in many women make you physically feel more comfortable in and out of clothing.
Surgery is often much easier and much less painful than many think. Usually, women can drive in 2 days, go out to dinner in 3 days, return to light work in 4 days, return to exercise in 3 weeks, and be in the pool or beach in 1 month.
Genetics and Lifestyle
Breast asymmetry may be related to genetics and may have developed during puberty or due to life events such as: normal aging and hormonal changes, pregnancy and breastfeeding, weight changes, accident or injury causing trauma to the breast, or conditions like scoliosis of the spine, pectus excavatum (depressed breast bone), and other genetic conditions such as Polands Syndrome.
Breast asymmetry can occur as a result of prior surgery of the breast from biopsy, prior implant placement, prior lift or reduction as well. Breast asymmetry causes challenges such as finding bras that fit comfortably, looking good in your clothing, being able to participate in sports or to workout in a gym without concern or embarrassment and wearing bathing suits with comfort at the pool without requiring constant “repositioning” of your breast and clothing. And breast asymmetry may simply be disconcerting just due to appearance.
Regardless of the cause, breast changes are unpredictable, usually unavoidable, bothersome, challenging, often uncomfortable, embarrassing and problematic.
How to Make the Decision
Few patients know where to start when considering surgery for asymmetry. The best way is to explore options during a consultation.
You may feel alone in these concerns. However, the challenges you may be experiencing are almost always shared by many others. Options for treatments will depend on the amount of breast tissue you have, your skin characteristics, and desire for a specific outcome.
Many women who think implants are required to have a well-proportioned breast, find that techniques for breast reshaping and lifts often result in great appearance without implants. Many who feel that they are too small often find that with repositioning breast tissue into a more symmetric and better space, they appear to have more projection and more aesthetically pleasing breast that work more comfortably with bras and clothing off the rack. Sometimes breast implants are considered as an option for volume enhancement as well.
No surgery is magic, and yet achieving improved symmetry with your breast can result in comfort and confidence in and out of clothing.
Breast Asymmetry Surgery Benefits
- Surgery creates or restores balance
- Surgery rejuvenates breast shape and contour
- Surgery re-contours the breast after pregnancy
- Surgery elevates and repositions the breast
- Surgery improves nipple/areolar size, shape, position and balance
- Surgery restores a more youthful, balanced and pleasing appearance to the breast(s) after random life events
Good Candidates for Surgery
Do you have any of the following concerns?
- Noticeably uneven breasts
- One or both breasts are shaped differently
- The nipple on one or both breasts are higher or lower
- Areolar(s) are misshapen and un-proportioned with the breast
- One or both breasts need more upper breast fullness
- Breast tissue sags low or at the bottom of the breast
- Bras fit poorly and are uncomfortable (one or both breasts)
- Inserts are needed to feel comfortable in clothes
- You feel conspicuous in workout, sports or swimwear
- Breasts have changed in shape, size, contour over time
- Random life events have caused undesirable breast changes:
Pregnancy, weight change, aging/hormone changes, trauma, illness
Regardless of your reasons, if you answered yes to one or more of these concerns, you could be an ideal candidate for Dr. Rudderman’s Breast Asymmetry surgery. Good candidates should be in otherwise good health, without a history of untreated breast disease or untreated illness or medical condition that can impair normal healing.
Dr. Rudderman believes the consultation is critical for you and him. The consultation includes the following: a thorough education of your options, an overview of techniques used to modify breast form, discussion on incisions, your desires regarding breast volume, desired appearance and body balance, careful, comprehensive examination to evaluate breast volume, tissue, skin characteristics and position, evaluation of your body frame, chest anatomy, and if implants are considered, a discussion of today’s breast implant options and safety considerations. During your consultation he will assess your anatomy, tissue and skin characteristics, breast volume, breast history, your desires for now and long-range, your options and he will create a personalized treatment plan that can be performed in a safe predictable way. Occasionally, you may require treatment for one breast that will differ from the other. These treatments are not an emergency, and plenty of time will be allowed to have a full conversation to consider options. Additional visits can be provided until you feel confident that you are making the best decision for yourself in health, safety, and outcome. From the consultation evolves a sense of trust, respect, mutual understanding, and a personalized treatment plan.
Dr. Rudderman is specialized in many surgeries of the breast and can perform the artistically demanding and rewarding surgeries that correct these problems. He is one of Atlanta’s surgeons of choice. He is specialized in many complicated problems of the breast and he employs delicate, advanced techniques to achieve the most natural-looking results possible.
The Breast Asymmetry Surgery
Most breast asymmetry procedures are accomplished with surgical incision placement that is similar to breast lift operations. In the procedures, the superficial skin and soft tissue are often elevated allowing for the breast tissue to be reshaped to a more normal anatomic appearance including often repositioning on the chest wall. This is accomplished by understanding and achieving the best possible balance between breast volume, skin and soft tissue, chest wall shape, nipple and areolar size and position. All of this is done after taking into consideration your height, shape, weight, age, lifestyle, and desires.
Surgery usually takes 1 to 2 ½ hours, is outpatient, and may involve a drain placement for usually 1 day. Women with a desk-type job almost always return to work on Monday after a Thursday operation.
Healing issues are rare if you are healthy and a non-smoker. Those that use tobacco products can reduce healing difficulty risk by reducing use before and after surgery. Women with children often can return to full childcare within reason in 3-4 days, including carpool and driving.
The operation and artistry are specific to each woman. During your visit, you will receive extensive education regarding your condition, your concerns, your options, your risks and benefits, and your probable predictable outcome. The goal is safe surgery, excellent appearance, normal anatomic redistribution, and an outcome that last for years and ages appropriately. Surgery is never permanent, and aging and other factors will impact appearance. The goal is for a revised breast to age naturally.
Written and reviewed by:
This article was written by Dr. Randy Rudderman, who is board certified by the American Board of Plastic and Reconstructive Surgery (1994). He practices medicine at his offices in Alpharetta and Atlanta.
Learn more about Dr. Rudderman, his medical training, and credentials.
Post Surgery Care & Recovery
- You will wake up with a small dressing over the treated area and a surgical bra.
- Mild swelling and some discomfort ares normal and to be expected. This resolves on its own and often requires some pain medication for 24 hours then only acetaminophen.
- You will be seen in the office 24 hours post-surgery and given a more comfortable bra.
- Swelling generally is mild and resolves in 1-2 weeks.
- Sutures are absorbable and do not need to be removed.
- You will have a type of brown paper tape on the incisions to protect the area and help with minimal scar formation.
- Most patients who have surgery on Thursday can return to desk work Monday.
- Avoid strenuous activity for 3 weeks.
- Dr. Rudderman will tell you when you can start to exercise again.
Measurable results are typically visible immediately, but be patient, healing and stabilizing takes time. It can take months for the “new you” to be clearly seen.
The results from this procedure are long-lasting. The breast can and will naturally age over time, but it is not common to need additional surgery for many years. Breast may not be totally symmetric due to the normal nature of the tissue, and typically larger breast are more subject to change over time due to skin changes and effects of gravity. All breasts need good long-term follow-up for evaluation of breast disease by your practitioner of choice.
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