Asymmetrical Breasts - Reduction/lift or Reduction/implant? (photo)

I am 26 5'2'' 145lb. I have had 3 children which left my breasts saggy. They have been asymmetrical since puberty but due to pregnancy/breast feeding, this has increased dramatically. I currently wear a 38dd,although i believe i'm supposed to be a 34g. I believe there is 2-3 cup size difference between my breasts. my left breast is not big enough and my right is WAY too large. I would be the happiest somewhere in the middle. Advice on whether to get an implant on L or just reduce R and lift L?

Doctor Answers 10

Major breast asymmetry is best corrected with a simultaneous vertical breast lift and implants

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You have major asymmetry and sagging.  Therefore, you need a minimum of a vertical breast lift.  However, that is not enough.  You also would be well-served with implants.  You might think, why on earth would I want an implant if I am too large already?  The reason is this is the  most effective way of restoring upper pole fullness.  Also, in cases of major asymmetry it gives the plastic surgeon a much more effective tool to make the breasts more symmetrical.  The difference would be a minimal tissue resection on the right and a major tissue dissection on the left, but implanst on both sides.  But don't take my word for it.  Look at before and after photos of other patients with asymmetry and see what you think.  I'm attaching a link to my website so you can look at photos of other patients with this problem.  You need an experienced surgeon. 

Kansas City Plastic Surgeon
4.7 out of 5 stars 61 reviews

Ultimate Lift and Reduction produces results similar to implants

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If you are satisfied with the volume of your right breast then you would need a lift on the right side and a reduction and lift on the left side.  I believe this would be the best procedure for you since no implant is required, it would be less expensive and you would not have the complications of implants.  It is difficult to achieve long term symmetry since the implants descend differently than the breast tissue.  You are an excellent candidate for a new technique called The Ultimate Breast Lift on the right side and The Ultimate Breast Reduction on the left side.  These techniques have no vertical scars or anchor shaped incisions.  The results appear similar to breast implants since the breast is reshaped and repositioned to create uppe pole fullness and increase cleavage.

Best Wishes,

Gary Horndeski. M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

What to do with uneven, asymmetric breasts?

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Thank you for your photos.  Ask yourself, is your left breast volume adequate for you?  If so, then a lift will suffice.  If not, you need an implant on that side in addition to the lift.  Your right side would be reduced to match whatever you choose through a reduction.  Implants bring risks with them.  If you do not need them, I would never suggest placing them simply to fulfill what I think a breast should be like.  You will need to decide on that and should discuss this further with your chosen surgeon.  Your problem is more common than you may think.

If you do an implant only on one side, that side will tend to stay fuller on top as you age and you may need additional surgery to maintain symmetry as best possible.  I tell my patients to expect more surgery every 10-15 years when you have an implant as something will happen that will need intervention if you wish to maintain the best possible results.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Improving Breast Asymmetry Options?

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Thank you for the question and pictures.

I think you can achieve much improved breast symmetry with breast lifting of both breasts and reduction of the larger breast.  It would be in your best interests  to have the procedure performed when you have achieved a long-term stable weight ( if you are not there already).

 Once this procedure is performed, you may decide that you wish to have fuller breasts ( for example more upper pole volume);  breast augmentation surgery may be helpful ( 2nd stage procedure).

 I would suggest that you select your plastic surgeon carefully; ask to see lots of examples of his/her work.

 Best wishes.

Asymmetrical Breasts - Reduction/lift or Reduction/implant?

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Thanks for the posted photos and interesting case. In my limited opinion based upon the info presented I would do a 2 staged approach. Stage one is a reduction/lift on the left and a lift on the right. Even insurance MIGHT cover this. Stage two after a few months  have right implant for symmetry. 

Options to correct breast asymmetry

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There are many possibilities including bresat reduction on one side, implant on the other, and different types of lifts to improve shape. Breast asymmetry can involve a size difference, shape difference, or rib cage asymmetry, so the combination of procedures will depend on analyzing those factors as well as the patient's goals. Since you mention that the smaller breast is too small then an implant on that side will make sense. From the photo there is sagging on both sides so a lift is in order, and this may include a reduction on the left if you feel that breast is too big. Correction of small volume differences may involve fat grafting but not likely in your case.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 56 reviews

Breast asymmetry can be corrected without implants.

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You will get the best long term result with a vertical (Lejour technique) breast lift on the right and a vertical breast reduction on the left.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Reduce or augment for better symmetry

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With one breast so large a reduction will be best for symmetry, with a lift on the smaller side. "Meeting in the middle" with a lesser reduction and an implant on one side alone might create issues with differences in projection and texture. We suggest that you avoid the implant if you can.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Brest Asymmetry Surgery

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The differences in breast size and shape between your two sides makes it very challenging to achieve even reasonable breast symmetry in the end. It make take two procedures to get the ideal result. Both sides need a lift but the bigger side needs a reduction as well as a lift. I would do a lift on the smaller side with an implant and a combined lift/reduction on the bigger side...with the caveat that it will be a lot better but far from perfect. Additional adjustments may be needed to refine the first foundational procedure.

Reduce and lift for better symmetry

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In your case the most symmetry will come from lifting your smaller side and lifting and reducing the larger one.  Using an implant on one side will only confuse the issue and make symmetry impossible.  The surgeon should do the smaller side first in surgery because that is the side that limits your size.  Then the larger one is done to next match the smaller one.  It will never be perfect but should be much better.

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.