I Had a Bilateral Mastectomy with Reconstruction of my Abdominal Tissue, They Are Not the Same Size. Can This Be Fixed?

Hi There,

I just wanted to let you know that it would be very helpful to the doctors if you were able to provide a photo. I know this is a sensitive subject, and although our photos are public, but I want to assure you that these are board certified doctors that answer your questions.


Doctor Answers 7

2nd stage procedures after DIEP flap breast reconstruction

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I believe your asymmetry can be safely corrected with an outpatient 2nd stage procedure.  

Without seeing photos, i would be curious as to whether you had radiation, whether your nipples were preserved, and how much asymmetry you had prior to surgery.

It is important to understand that breast reconstruction is a process.   A mastectomy surgery takes away the size, shape, and symmetry of the breast.   In order for your plastic surgeon to recreate these variables, it often takes 2-3 staged procedures.

I wish you a safe and healthy recovery.


Dr. Gill

Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Breast reconstruction using your own tissues

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If you have undergone a TRAM flap for both breasts and you are asymmetric, then you may be a candidate for a revision of your reconstructed breasts.  This procedure is usually covered by insurance.  Please followup with your reconstructive plastic surgeon to  discuss your options

Breast asymmetry after reconstruction

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It sounds like you had bilateral breast reconstruction with your abdominal tissues?  So I am assuming that you had a bilateral DIEP or TRAM flap?   If so, then there are options to improve your symmetry.  Please visit with your plastic surgeon for a follow-up to learn more about your options.

Dr. Basu

Houston, TX

Breast reconstruction, nipple reconstruction, breast cancer, DCIS, mastectomy, TUG flap, DIEP flap, Latissimus flap, fat graft i

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I am unclear by the question.  DIEP flap reconstruction done for bilateral reconstructions use an equal amount of tissue from the abdomen for each breast reconstruction.  The Breasts are asymmetric in many instance because they always were or because of previous surgery for radiation therapy.  Using fat grafting after mastectomy is an effective way to treat size and shape differences.  Fat grafting is performed by removing fat with a liposuction cannula and then processing the fat and re-injecting the fat into areas of the reconstruction that need more fullness.  Typically this is at the top where there can be a shelf or the side.  

Breast Reconstruction Asymmetry can be improved in most cases

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Without photos I can only give you a general answer. It is common for  reconstruction breast asymmetry to be corrected secondarily.

Breast reconstruction revision

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Dear Lisa,

While it is difficult to answer your question without at least pictures, generally, this can be done and often required. It sounds as though you have had bilateral TRAM flaps and may benefit from fat transfer, another flap or small implants. This is a discussion best had with the surgeon who performed your reconstruction. Best of luck.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 115 reviews

Breast Reconstruction

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Asymetry in size can be corrected and you have several options. It will depend on the mall difference can be corrected with fat transfer, you may have the option of implant or even a latsmus dorsi flap.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.