When breasts don't develop
as yours has, procedures can certainly help make them better. Achieving symmetry is the goal but perfection will be elusive in your situation, due to the differences in native tissue and how it 'hangs'. Most surgeons can achieve a very good result without anything more than an augmentation on your right side and augmentation mastopexy (or even reduction) on your left side, using sizers to help choose the best match or saline implants that have some variability in volume. I'm sorry you are having to deal with this but at least it is a fixable problem.
No, you do not need a tissue expander to create equal and symmetric breasts. Use of different volume saline implants would be most useful.
You do not need anything fancy such as a breast expander or tissue matrix, etc. All you need is a plastic surgeon who is well versed in performing simultaneous breast aug and lift. Please see photo of patient below who had severe breast asymmetry treated with breast aug and lift.
Asymmetric breasts with a constricted fold on one side and tuberous breast on the other.
I do not think you need a tissue expander. Certainly, different size implants need to be used and a lift on the left would certainly help with obtaining the most symmetric results. I would suggest seeing an experienced cosmetic breast surgeon who should be able to show you before and afters of his work with asymmetric as well as tuberous breasts.
I have tuberous breasts. Would I need a tissue expander to fix my smaller breast?
You will get many different opinions. If you don't have a 2 stage procedure with a tissue expander in the right breast, you will be restricted to the shape and size obtained by scoring techniques to release the constricted lower pole of the breast and the placement of an implant. You may or may not be able to achieve a D-cup breast based on how tight your skin is. And, since the left breast has much more skin, it will always look different, even with the breast lift you will require to elevate the nipple and the smaller implant needed to get upper pole fullness to match the augmented right breast. If you undergo tissue expansion of the right breast, the tight skin will be much less of a restricting problem, you should be able to achieve the size you are hoping for, and you have a better chance of better symmetry with the lifted and augmented left breast.
Tuberous - Constricted Breast
I would not use a tissue expander. I would discuss with you doing a bilateral augmentation with a significantly larger implant on the right side and a smaller implant with breast lift on your left side.
Constricted ...Tuberous breast are challenging to get a good result on. You will always have a different shape although the volume will be very close.
I would recommend seeing a plastic surgeon with a great deal of augmentation experience...you will need some special surgery inside to score and open up your breasts and may need some fat grafting in 9-12 months.
All my Best!
Bradley Bengtson, MD
I have tuberous breasts. Would I need a tissue expander to fix my smaller breast? I'd like to be a small D cup
Thank you for your question and photographs. As you have discovered, if you ask several surgeons their opinions, you will get several different answers for what appears to be the same problem. Many times tuberous breasts can be corrected in one setting, without the need for a tissue expander. Depending on the degree of asymmetry, tightness of your skin envelope, and the breast size that you are looking to obtain, a tissue expander is also an excellent option. I would suggest you find the surgeon that you feel most comfortable with, and who's explanation as to why they are recommending a particular type of procedure makes the most sense to you.