Always had uneven breasts - born with scoliosis - how do I fix this? (photo)

Candidates for Breast Lift (#Mastopexy) surgery are women who have #saggingbreasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume. One side can be tightened more or less than another.Intended ResultA mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

A breast lift for the larger, droopier breast coupled with fat grafting to the smaller breast may be reasonable based upon the photos presented.

Thank you for your question and your photo.  All women naturally have some asymmetry of the breasts.  In your case, it appears that you may have tubular breast deformity with an elevated inframmary fold and herniated breast tissue.  To correct your deformity, a combination of  following could be a possible solution:

-  right breast augmentation with lowering of the inframammary fold and fat grafting of the upper pole

-  left breast augmentation and mastopexy with lowering of the fold

An additional session of fat grafting may be necessary to address any subtle contour irregularities.  A consultation with a board certified plastic surgeon would be a great place to start!

Thank you for your question about breast lift and breast asymmetry. Thank you for the picture.The most straightforward way to correct your breast asymmetry is to have a breast lift on one side only.Yes, breast fat transfer is possible but can be problematic if done simultaneously with a breast lift. The non-lifted side may be amenable to breast fat transfer.

To be sure what would be best in your particular situation, it's recommended you see two or more board-certified plastic surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have breast lift surgery.

I hope this helps.

I appreciate your questionWith your severe asymmetry it would be best to have an in office consult for implants and a lift.

After performing hundreds of breast augmentation-mastopexies (breast lift with implants), I think the most important thing I try to convey to patients is that this surgery is a lot more complex since it is a combination. We are increasing the size of the breast by placing implants while simultaneously making the breast smaller by removing skin to perform the lift, which tightens the breast.  This could lead to complication loss of skin and the nipple due to vascular compromise. Also since most breasts are asymmetrical there is a larger possibility of having asymmetry after the procedure and meeting a revision.

I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured. 

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast and is a very attractive option for individuals seeking a natural-looking breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability and shape. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

Saline implants tend to be firmer and less natural looking. They are a silicone shell that is filled with water. They have a higher chance of rippling if you are thin especially on the side. However if the implant does structure your body will absorb the water and you will know right away about the deflation. 

During your breast augmentation consultation, you will feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast. The Scar patterns are determined by how much is skin we need to remove how are high up we need to move the nipple. If your breasts are very large, you might benefit fro  my lipo-lift procedure and the fat we remove could be used to increase the size of cleavage of your breast while lifting them.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Board Certified Plastic Surgeon 

#RealSelf100Surgeon

#RealSelfCORESurgeon

All women have breasts that are asymmetric, there are no 2 breasts that are exactly the same, just like snowflakes.  Fortunately, there are many procedures that can be performed to make the breasts more symmetric.In this situation;  The right breast is smaller in volume than the leftBoth breasts have a high crease and a tubular shape, left worse than rightThe diameter of the areola is too wide in comparison to the breast sizeBoth breasts are smallThe cleavage area is very wideI would recommend the following:Concentric (donut) mastopexy to reshape the breasts and decrease areola diameterWide based silicone implants under the muscle to increase size and improve cleavageLarger volume implant on the right than the leftFat grafting is a very inexact science, some fat lives and some fat dies, making procedures to achieve symmetry very difficult.  With implants we can sit our patient's upright during the procedure and adjust the implants until symmetry is achieved.  This is a permanent correction, we don't have to worry about fat grafts taking or dying.  Also, there is no donor site issues such as pain and healing from the fat removal areas.This type of procedure is very common, and can be performed as an outpatient with a quick recovery, I would anticipate an excellent result.  Please see a Board Certified Plastic Surgeon who specializes in breast enhancement procedures to assure the best possible result.Good Luck!

Based on your photo, most of your asymmetry is due to increased size and ptosis of the left breast.  It is difficult to tell how much of the asymmetric appearance is due to your scoliosis, if any.  For a more symmetric appearance, the left breast could be lifted, with placement of a small implant vs fat grafting on the right.

Thank you for your question. I completely see what you are talking about. Without the use of implants, the easiest solution would be to lift the left breast (likely with a vertical or lollipop lift), and to fat graft the right breast. You look to be fairly thin, so finding enough good fat (likely about 200-300ccs) may be difficult, but most people have some to give in the flank region. Most patients need two rounds of fat grafting, as you tend to lose some with each treatment. It's a lot to think about, but yes - you can definitely be made more symmetrical. Best of luck! 

Thank you for your question and photos. A breast lift on the left lower side will improve the asymmetry. If you want the smaller breast to be fuller and do not want implants then fat transfer is an option. To learn more please read below: