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Correcting Breast Asymmetry

Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson explains his approach to correcting asymmetrical breasts.

In my experience, 90 percent of women who present for breast surgery of any type have asymmetrical breasts. Many of these patients do not realise their breasts, and possibly even their chest wall also,are asymmetrical.

Uneven breast size should be addressed at the initial consultation. The asymmetries can consist of a difference in the actual breast size, the position of the nipple areolar complex, the breast position on the chest wall and the position of the chest wall in relationship to the spine. Occasionally, there are asymmetries of the pectoralis muscle on which half of the breast sits.

If nipple areolar complexes are asymmetrical to the point of only 2cm, most women do not seek corrective surgery. However, if the difference is greater than 2cm, lifting the nipple areolar complex with a periareolar mastopexy can be an effective solution.

Volume discrepancies can generally be corrected by using different-sized implants for breast augmentation. In the case of a breast reduction operation the asymmetry can be addressed by removing more tissue from one side than the other in order to try to get the breasts as symmetrical as possible.

Case study 1

Pre- and post-bilateral minimal-incision breast lift and
augmentation by Dr Hodgkinson to correct
asymmetry and droop

Asymmetry with droop
The most common problem seen by women seeking breast augmentation is droopy breasts. While some surgeons are tempted to simply place an implant in the breast, this will not correct the droop but make the deformity more obvious. In this scenario, a breast lift is performed at the same time that the implant is inserted. The incision is placed around the nipple to prevent scarring on the breast itself.

Case study 2

Pre- and post-unilateral minimal-incision breast lift with
bilateral breast augmentation by Dr Hodgkinson

Asymmetry with tuberous breasts
For tuberous breast(s), a lift or form of reduction is necessary to the tuberous breast(s) prior to augmentation with implants.

Case study 3

Pre- and post-insertion of customised unilateral silicone
chest wall implant and bilateral breast augmentation
by Dr Hodgkinson for chest wall deformity

Asymmetry with chest wall deformity
Chest wall deformities such as Poland’s Syndrome, pectus excavatum (sunken chest), pectus carinatum (pigeon chest) and even scoliosis can affect the way in which a woman’s breasts appear. It is important to address the issue of any chest wall deformity at the same time as considering breast enhancement.