my daughter is almost 14 and has started her periods. her left breast is an 'a' cup where as her right breast is almost a 'd' cup. she has been refused nhs treatment for her condition until she is 18. is there any private clinics in the uk that would be willing to do corrective surgery on someone so young? also, i have been given no self help infomation with regards to exercise that may enhance the growth of the smaller breast and no infomation was offered of where specialist bra's and swimwear can be purchased. can you help?
Help for Teenager with Uneven Breast Development
Doctor Answers 8
Teenager with uneven breast development
As the father of a 14 year old girl, I FULLY sympathize with you. But as Americans embroiled in our own current debate on inventing our own version of your NHS in the US -- we cannot really comment on the benefits of your NHS or the lack thereof.
In your case, it sounds like your daughter has significant breast asymmetry which MAY even be a mild form of POLAND'S SYNDROME.
The breast completes its growth by age 18 to 19 years. Depending on the level of anxiety and psychological impact it has on her, reconstruction could be delayed until then or be started earlier. Usually, a breast tissue expander can be placed on the right. It would be slowly expanded, producing more breast skin (and decreasing the visible disparity between the breasts) so when the breasts are mature (age 18 or so), the expander is removed and depending on the needed volume the right breast can be filled with either a Latissimus Dorsi (back) muscle with or without an implant.
I would check the http://www.bapras.org.uk/ and see which of its members you could see privately. With the venerated Harley Street model, there must be qualified FRCS Plastic surgeons who would take cash or private insurance in the UK.
Asymmetric breast size
Breast asymmetry should be addressed once growth has stopped
I would tend to agree with the other experts in that breast asymmetry should really be addressed once breast development is complete. With the degree of asymmetry that your daughter has, it would be unfortunate to put her through a big surgery only to have the results change over the next few years. As for exercises, don't waste your time. Exercise will only affect the muscle and this is not the problem here.
I hope that helps.
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You have been provided with wise advice.
Performing surgery too early could result in needing more surgery later due to ongoing changes in breast development.
It is always better to wait until the breast are of full size and have not grown anymore. She most likely will grow a bit more. When they do not grow anymore, it will be easier to adjust the volume on each side then doing something now, and seeing a growth spurt.
Correction of breast asymmetry.
This degree of breast asymmetry is usually associated with a lot of emotional suffering. So I think it is perfectly appropiate to do corrective surgery on your daughter now. But you need to understand that she will almost certainly need further surgery when her breasts have finished developing (age 18 to 20).
Exercises will not help. Until she has surgery, you can get her a prosthesis to fit inside her bra at a store that caters to mastectomy patients.
14 year old with breast asymmetry
You would do well to wait until her breast size has stabilized for one year. You need to know what the ultimate size and size difference will be before you try to make a correction. Otherwise age is really not a factor.
What can be done for an adolescent with asymmetrical breast development?
In managing the problem of prominently asymmetric breast development, I believe it is equally important to be cognizant of the social issues, as well as the surgical and anatomical ones...
The reason you are unable to find help via the NHS is because it is likely that your daughter's breasts will continue to develop and change until at least that time (some women's breasts continue to change even longer), and no responsible surgeon would normally recommend putting a patient through more operations than necessary to achieve a desired outcome. Hence the rationale for waiting until she is fully developed- by doing so, you are hopefully reducing the risk that her breasts change after surgery (if the surgery were performed now), and minimizing the risks of her needing further surgery in the future.
On the other hand, I have treated enough young women with prominently asymmetric development of the breasts to know that this can create a devastating social situation for them.
It is very important to balance the surgical treatment, its recovery and risks with the benefit to her psyche of pursuing correction early. If her current situation is not overly problematic for her, and you think waiting a while would not cause undue psychological and social trauma, I would wait as long as you can to pursue treatment.
If, on the other hand, you see your daughter becoming withdrawn and reclusive, and she complains that she is unhappy frequently (you'll have to gauge this yourself since all teenagers seem to have a baseline level of discontent), perhaps pursuing earlier management would make sense.
In either case, I would find a surgeon with a lot of experience managing this situation. You want whatever treatment option you pursue to not be limiting to her future options. This requires careful planning.
I hope that helps you.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.