I want to know what can be done to correct my asymmetric breasts?

I am overweight by a significant amount. On top of that and my severely deformed breast I have huge issues with self esteem. I'm wondering what can be done to correct my deformity. I want my breasts to be the same size, perkier, fuller, and for the nipples to be smaller. I also want to know if I need to lose all the weight (120-130lbs) before I can get surgery. (I am 265 now) Once I am eligible for surgery, what sort of procedures need to be done to reach the results I want? (pics included)

Doctor Answers 9

What can be done to correct asymmetric breasts?

It is best to procede with surgery after you have reached your final goal weight . A lift will be required. Whether or not an implant would be required depends  on your overall final volume and whether you want more stable upper pole fullness. Best wishes. 


Philadelphia Plastic Surgeon
4.9 out of 5 stars 52 reviews

#breastimplants

Thank you for sharing your photos.  Will be good that you lose weight  before  under go to this kind of procedures, but  we can reduce and lift the breasts to get  an excellent results. The details of the procedures can be determined in the medical evaluation with your PS 



 I hope my answer will help you to your question.
Before undergoing any surgical procedure, please seek a board certified plastic surgeon

Jairo Ulerio, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 55 reviews

Breast augmentation

Congrats on your conviction on losing weight! I think that is the first step to getting the results you want. Once you have lost the weight you will need a breast lift and probably a breast augmentation to create that appearance.  Keep those pictures sitting on your nightstand. Every bit of motivation helps!Good luck! 

Mark T. Boschert, MD
Saint Louis Plastic Surgeon
4.9 out of 5 stars 19 reviews

#WeightlossBeforeBreastAugmentation

Once you have changed your lifestyle and are at a stable weight for some time, you should do well with a breast lift and augmentation. 

Breast lift

Thank you for your post, and I'm sorry to hear you are so upset about your breasts. Definitely work on weight loss first. Once you meet and reach a reasonable goal, then you can plan a surgery. You will need a breast lift (mastopexy), and often an implant is needed to get that roundness at the upper portion of the breast like you show. Best wishes.

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 7 reviews

Weight Loss First

Yes, you need to lose the weight first. Not only will it be better for your health in terms of surgery, but it will affect the size and shape of your breasts. Which will then determine which procedures are right to address your issues. In most likelihood, you would be a good candidate for a breast lift with an implant, but an in person exam is going to be the only way to truly give you an accurate recommendation. I would suggest that once you get to a manageable weight, schedule a consultation with a board certified plastic surgeon in your area to discuss your options. Bravo for taking care of your health. Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

Definitely lose the excess weight before surgery

Thank you for your question and photographs. You definitely should lose the weight before surgery and to improve your overall health. You should calculate your body mass index (BMI) at at least get it below 30 before considering surgery. Depending on how your breasts change in size with weight loss will determine what procedures need to be done to come close to your ideal shape and size. At the very least, you will need a full breast lift. Be sure to see an experienced board certified plastic surgeon.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 35 reviews

I want to know what can be done to correct my asymmetric breasts?

Thank you for the question.  You will be best off achieving your long-term stable weight prior to proceeding with elective breast surgery. You will find once you do so that you will likely be a good candidate for breast augmentation/lifting surgery.  Some general  thoughts regarding this combination surgery may be helpful to you:


Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.

Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%.
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.

To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts.

Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.

For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).

Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).

Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.

I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future. The attached link may also be helpful. Best wishes as you work towards your goals.

Weight loss before surgery

It would be important to lose the weight first both from the standpoint of your overall health and for the cosmetic result.  Once you have achieved that, you will need at least a lift, and in order to get the kind of result in the picture probably an implant as well. Good luck.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 26 reviews

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.