Is Symmetry Difficult to Achieve with Breast Reconstruction?

Complete symmetry for any breast surgery and especially for reconstruction post mastectomy is an illusive goal especially as a single stage. It is more likely when you are trying to match a small breast without much sag. Without photos it would be impossible to give a more detailed opinion. Not to be discouraged when the breasts are not symmetric, much of the time the patient prefers the reconstructed breast.

Symmetry is our constant goal following mastectomy and breast reconstruction. The two key factors to consider are:


the shape and size of your breasts

any sagging and excess skin.


We use a variety of techniques to maximize symmetry. The other breast may be adjusted with the use of implant and/or a breast lift, or breast reduction. If operations on a breast are required to achieve symmetry, that surgery is covered by all insurance plans, thanks to federal legislation.

Complete symmetry is always a challenge in breast reconstruction. This is especially true in one-sided reconstruction (unilateral). As plastic surgeons, our goals usually are to try and re-create a breast mound that looks like a breast and to provide as much symmetry as possible.  Be patient, if often requires multiple operations.

The hardest part of a unilateral breast reconstruction is trying to match the other side.  Often times, you need to alter the normal breast to better match the reconstructed breast. This may include any combination of procedures, from an augmentation to a lift to a reduction, etc.  even then, there is always some asymmetry.  The goal is to get it as close as possible.  Unfortunately, when you are dealing with one breast that has gone through a mastectomy/reconstruction, overtime it will act differently then the normal breast.  It may not settle as much, may be firmer over time, etc.  This is why breast reconstruction is a lifelong endeavor for a patient - over time there are often small revision surgeries to maintain symmetry. I hope this helps.

Symmetry can be approached with breast reconsrtuction, but no one is exactly symmetric.  There are many options for breast reconstruction including tissue exapnders and implants, latissimus flaps with implants, fat grafting for small contour problems, TRAM flaps, DIEP flaps, SGAP, and IGAP flaps to name a few. You require an exam first to figure out what is best for you..
 

Post-mastectomy reconstruction is potentially humbling for both the surgeon and patient, alike. It's essential to emphasize that perfect symmetry is never possible for the following reason: the reconstructed breast mound is a "static" entity, it will never age or sag in the same fashion as the opposite side. While it may become encapsulated, thereby getting narrow, firm and rising upwards, it won't droop the same way as the noncancerous side. There are always "balancing" operations which can be offered, such as a breast lift/reduction or implant, however the effects of time and gravity are much more evident on the noncancerous side. Good luck.

Symmetry is a goal that is rarely achieved in breast reconstruction, especially in a single stage. In general, since the breasts are paired structures, if you do similar procedures to each side, you are more assured of getting a higher level of symmetry. This rarely happens, but if you have an implant on one side, you should devise a plan that puts an implant on the other. If you don't want an implant in your good side, you shouldn't have an implant reconstruction. If your surgeon plans things well, and your situation allows it (i.e. no radiation), then it is possible to get very close symmetry but it usually requires at least a coupe of procedures.

In a one sided breast reconstruction, trying to match the opposite natural breast perfectly is almost impossible with an implant but is more achievable with a tissue reconstruction. Perfect symmetry isn't a realistic goal in this setting but substantial improvements should be made if you choose an excellent and experienced surgeon and also depending on what your own starting point is. Radiation treatments also eliminate the possibility of perfect symmetry.