Breast Distress: What are your options?

A. Foley on 4 Oct 2012 at 9:00am


There are plenty of problems that can plague your frontal area and have you considering a trip to the plastic surgeon. Fortunately, if you're unhappy with your breasts, there are options to address a variety of woes —but what is best? A lift? An enhancement?

Let’s run down the list of common bust concerns, and the best doctor-recommended options for each.

Diagnosis: Teeny-weeny bikini area

The Concern: Some women with smaller breasts crave a larger cup size to feel more confident.

Option: To obtain a bigger bust, most surgeons recommend breast implants. While there are other alternatives out there, most are either ineffective, such as suction or enlarging of the pectoralis muscles, or controversial, such as fat transfer into the breasts.

“If one is self conscious about the size of one's breasts and desires larger breasts, I think breast implant surgery is the best option,” said RealSelf plastic surgeon James Tang, MD. The benefits he cites include: “They are safe and generally permanent. Once can breast-feed afterwards. Mammograms and self examination can be done afterwards for early detection of breast cancer.”

Of course, if you're not keen on permanent enhancement, there are plenty of push-up bras out there that can cradle your cleavage and give you a confidence boost without surgical interference.

Diagnosis: Burgeoning boobs

The Concern: On the flip side, extra-large breasts are no picnic, either. Many top-heavy ladies suffer from back problems and constant pain.

Option: It depends. Because there are so many different ways to perform breast reduction, the options for a procedure depend on how small you want to go, where the fat and tissue needs to be removed from, and the shape of your breasts, among other things.

RealSelf plastic surgeon Jeffrey M. Darrow, MD, said, “There are several techniques used in breast reduction, each with their positives and negatives. The individual technique is likely not as important as the experience of your surgeon.”

However, most surgeons do agree on what's not the answer. “It is a rare patient who is a good candidate for breast reduction alone,” said Tom J. Pousti, MD, FACS, a RealSelf plastic surgeon. “The results achieved by reduction are minimal to moderate at most.”

Diagnosis: Perk-be-gone

The Concern: Sagging breasts can be caused by a number of things, from the hormonal fluctuations of childbirth and breastfeeding to the gravity of aging.

Option: While women with drooping boobs can keep the ladies at attention non-surgically with a push-up bra, surgery is another alternative for restoring au naturelle perkiness—usually through a breast lift. Plastic surgeon Rod J. Rohrich, MD, said, “The best method to correct sagging breasts is a “mastopexy” or breast lift for optimal results. One can do this with or without implants, but if you want superior fullness with a mastopexy, then one needs to add breast implants.”

Diagnosis: Uneven Steven

The Concern: These things are supposed to be the same size, right? Women with uneven or asymmetrical breasts find it hard to get comfortable in a bra, and can often struggle with self-confidence.

Option: There is no one single right way to adjust uneven breasts—but only because there are multiple reasons that you might have a mismatched pair. Each cause has different alternatives for repairs.

Brooke R. Seckel, MD, a Boston plastic surgeon, explains: “If the smaller breast has not developed normally or is a tuberous breast, some type of reconstruction using a breast implant will be necessary. However, if you have adequate breast tissue with one breast simply larger than the other normally shaped breast, the larger breast can be surgically reduced in size to match the other smaller breast.

“If one breast sags more than the other—a condition called breast ptosis—a breast lift or dermal mastopexy can be done to lift the breast to match the non-sagging side.”
And for a non-invasive solution, there are comfortable bra inserts (usually filled with silicone, water, or natural oils) that can give you a natural-looking symmetry when you use just one.

Do you have a breast concern that we didn’t address? Tell us about it in the comments!


photo credit: Dr. Ramin Behmand, MD