For clarification, our bodies are not symmetrical and ALL patients have some degree of asymmetry between right and left breast (breast asymmetry). This blog article will discuss major breast asymmetry and surgical options for correction of “uneven boobs”.
The obvious question is if the breast asymmetry is due to asymmetrical growth of the breast or is there an anatomical or mass reason for the uneven breast size.
One of the most common congenital causes of uneven breast development is Poland Syndrome. In this situation, there is deficient or absent growth of the pectoralis major (the chest muscle) on one side which causes breast asymmetry. There are also associated abnormalities of the fingers such as webbing or shortening of the fingers. However, in rare occasions, there can be involvement of other organ systems of the body, which may require medical or surgical treatment. In most cases, the asymmetry can be minimized with breast augmentation on the affected side.
Another cause of asymmetrical breast development, especially in the young or teenage female, is giant fibroadenoma. These tumors can become enormous and frequently cause dilated veins in the breast. Radiology studies show a well demarcated mass consistent with the diagnosis. Fortunately, these tumors are not malignant, and although quite large in size, are easily enucleated from the normal breast tissue. The patient, however, may end up with a reverse asymmetry (the operated breast may be much smaller than the normal breast). The patient may require a breast augmentation with or without a breast lift.
Obviously, a malignant tumor should be ruled out if there is any doubt about the pathology of the breast mass. The treatment, if malignant, can be lumpectomy with radiation therapy or total breast removal with breast reconstruction.
Most cases of significant breast asymmetry are simply idiopathic: no known cause can be identified. The asymmetry can be reduced by using different size breast implants with or without a breast lift (if one or both breasts have drooping of the nipple and loose breast skin). In these cases, I generally recommend using saline implants, since the volume of the implant can be adjusted intra-operatively, maximizing the chance of obtaining better breast symmetry.
I have attached a video of a patient with significant breast asymmetry and ptosis (drooping) on the right side.
In ALL of these cases, it is important for the patient to realize the goal is toward normalcy and not to enhance a normal pair of breasts. In a way, these surgeries are more reconstructive than cosmetic in nature, and patient expectation should be more realistic. Having said this, for the right patient, the results can be very rewarding with high patient satisfaction.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call (714) 834-0101.
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