Mark McRae, MD

Breast and areola asymmetry following unilateral breast reduction is a common concern for many women who have undergone this procedure. While breast reduction surgery aims to improve breast symmetry and proportion, it's important to understand that achieving perfect symmetry is not always possible. In your particular case are you overall more symmetric in terms of your breast volume, breast shape, and nipple position? When repositioning the nipple, a smaller areola is most often created. There are a range of sizes so you and your surgeon have some choice, but depending on the size you started with, a smaller size more likely. In a bilateral procedure the smaller areola is in most cases more aesthetic. Unfortunately when only one breast is operated on, this can result in areola assymetry. The good news is that the areola size of your smaller breast can be made smaller, and repositioned if needed to further improve your symmetry. Some changes in breast shape can also be achieved if needed. Make sure you discuss this with a board certified plastic surgeon and take the time to make sure all your questions are answered before proceeding.

Hi there I hope this helps. This is a similar answer to one I provided to another women recently: Predicting cup size in a breast reduction consultation is a common concern for many women seeking this procedure. However, it's essential to understand why accurately predicting cup size is not always feasible and why it shouldn't be the primary focus of the consultation. First and foremost, cup size is a notoriously unreliable measurement of breast size. The concept of cup sizes can vary significantly between different bra manufacturers and even between different styles within the same brand. Factors such as band size, breast shape, and individual body proportions all contribute to how a bra fits and what cup size it corresponds to. Therefore, basing expectations solely on achieving a specific cup size can lead to disappointment and unrealistic goals. During a breast reduction consultation, the focus should instead be on discussing your goals, concerns, and desired outcomes. A skilled and experienced plastic surgeon will assess factors such as breast volume, symmetry, nipple position, and overall breast shape to develop a personalized surgical plan that addresses the patient's unique needs. This plan may include removing excess breast tissue, reshaping the breasts, and repositioning the nipples to achieve a more proportionate and aesthetically pleasing result. A good rule of thumb is that the breasts will be reduced by about half of their current size in a breast reduction. Some patient will say that is too much, others will say that is too little. It is helpful when trying to figure out whether someone is looking for a reduction or a lift. However in general this approach leaves enough tissue to recreate a pleasing aesthetic and keep the breast size harmonious with the rest of the body as we mature. Now no 2 patients are alike, but that is why this is simply a rule of thumb. Additionally, predicting cup size after breast reduction surgery is further complicated by the fact that breast size can change over time due to factors such as weight fluctuations, hormonal changes, and pregnancy. While the goal of breast reduction surgery is to create long-lasting results, it's important to recognize that individual outcomes can vary, and some degree of unpredictability is inherent in any surgical procedure. In your case you should wait 6 months after completion of breast feeding to get an accurate reading of the volume of your breasts. Again variable but many women will deflate further. Instead of focusing on cup size, focus on communicating your desired aesthetic outcome and trusting the surgeon's expertise to achieve the best possible results. Make sure you connect well, look at their before and afters, and see if you like their aesthetic. By approaching the consultation with realistic expectations and a collaborative mindset, you can work together with your surgeon to create a surgical plan that aligns with your goals and delivers a satisfying outcome that enhances both physical appearance and your quality of life.

Predicting cup size in a breast reduction consultation is a common concern for many women seeking this procedure. However, it's essential to understand why accurately predicting cup size is not always feasible and why it shouldn't be the primary focus of the consultation. First and foremost, cup size is a notoriously unreliable measurement of breast size. The concept of cup sizes can vary significantly between different bra manufacturers and even between different styles within the same brand. Factors such as band size, breast shape, and individual body proportions all contribute to how a bra fits and what cup size it corresponds to. Therefore, basing expectations solely on achieving a specific cup size can lead to disappointment and unrealistic goals. During a breast reduction consultation, the focus should instead be on discussing your goals, concerns, and desired outcomes. A skilled and experienced plastic surgeon will assess factors such as breast volume, symmetry, nipple position, and overall breast shape to develop a personalized surgical plan that addresses the patient's unique needs. This plan may include removing excess breast tissue, reshaping the breasts, and repositioning the nipples to achieve a more proportionate and aesthetically pleasing result. A good rule of thumb is that the breasts will be reduced by about half of their current size in a breast reduction. Some patient will say that is too much, others will say that is too little. It is helpful when trying to figure out whether someone is looking for a reduction or a lift. However in general this approach leaves enough tissue to recreate a pleasing aesthetic and keep the breast size harmonious with the rest of the body as we mature. Now no 2 patients are alike, but that is why this is simply a rule of thumb. Additionally, predicting cup size after breast reduction surgery is further complicated by the fact that breast size can change over time due to factors such as weight fluctuations, hormonal changes, and pregnancy. While the goal of breast reduction surgery is to create long-lasting results, it's important to recognize that individual outcomes can vary, and some degree of unpredictability is inherent in any surgical procedure. In your case you should wait 6 months after completion of breast feeding to get an accurate reading of the volume of your breasts. Again variable but many women will deflate further. Instead of focusing on cup size, focus on communicating your desired aesthetic outcome and trusting the surgeon's expertise to achieve the best possible results. Make sure you connect well, look at their before and afters, and see if you like their aesthetic. By approaching the consultation with realistic expectations and a collaborative mindset, you can work together with your surgeon to create a surgical plan that aligns with your goals and delivers a satisfying outcome that enhances both physical appearance and your quality of life.

The ability to breastfeed after breast reduction surgery varies greatly among individuals and depends on several factors. While some women can successfully breastfeed after the procedure, many will encounter challenges or find it impossible. Even with meticulous technique, reducing the breast will reduce your ability to successfully breast feed. The extent of breast tissue removal during the surgery is a key factor. If the milk ducts and nerves are minimally affected, there's a higher chance of being able to breastfeed. These challenges can include insufficient milk production, issues with milk letdown, or difficulties with latching. Damage to the milk ducts and nerves during the procedure impact milk production and flow. Women who are considering breast reduction surgery and wish to breastfeed in the future should discuss this with their surgeon beforehand. Surgeons can provide insight into the potential impact of the surgery on breastfeeding and may employ techniques to preserve breastfeeding function. I tell all women that have a strong desire to fully nourish their child with breast milk, to delay breast reduction until after children. Seeking support from lactation consultants, breastfeeding support groups, or healthcare providers experienced in breastfeeding after breast surgery can be invaluable. They can offer guidance, support, and practical strategies to address breastfeeding challenges and optimize the breastfeeding experience. The ability to breastfeed after breast reduction surgery varies from person to person, and it's essential to approach the decision with realistic expectations and a supportive network in place. Ultimately a fed baby is the most important thing. Even if you have less supply, and have to supplement on top of breast feeding, you and your baby may still see many of the benefits of breast feeding.

This is a difficult problem and you will get incremental improvements with lower blepharoplasty, and fat grafting, but complete resolution will likely require some direct excision of the festoon itself. One of my favourite lower blepharoplasty techniques blends the orbital fat with the cheek fat and improved the transition between the lid and cheek. The festoon however is below this transition point and will not completely disappear. Fat grafting can also fill in hollowing of the midface and you will see some benefit with that in your case also. But not complete resolution Nonetheless the festoons will still be present (with some improvement). At that point a direct excision of what remains is required to remove the skin excess at that location on the cheek. It is a big step to accept a scar on the cheek. It is much easier to accept a scar on the cheek in older people with more rhytids and sun changes that hide the scar. However the scar will fade with time and good skin care. And right now the demarcation causes a major shadow- a fine scar will be far less noticeable. Hopefully this picture was taken at a point in time when you still had some inflammation that may improve more. I hope you find this helpful. I certainly have treated many patients with this and it takes time to make sure patients understand what improvements surgery will provide. Having knowledge of the process and a step wise approach, as well as a knowledge of the pros and cons should help you as you choose your path forward.