I'm a veteran & I have been approved for a breast augmentation through that VA hospital. I have severe Breast asymmetry.(photo)

Question

My surgeon wants to place an implant in my smaller breast and simply lift my larger breast. I am worried that they are still going to look aysemetric due to one being real and one having an implant. (I know they won't be perfect but) Unfortunately because it will be through the VA hospital and they are covering the cost I get the surgeon that is assigned to me. Can anyone show me before and after pics that may be similar to my situation where a patient only had one implant?

Paul Vitenas, Jr., MD · Answer

Thank
you very much for your question and photographs.  Clearly you have a marked sag in both the volume
and length of your breasts.  The plan in which
your surgeon has outlined will certainly provide an improvement in the way your
breasts currently look.  Remember, no
amount of surgery will produce perfectly symmetrical breasts, if in-fact you decide
at some point in the future to have an implant placed on the right side.  However, I would suggest at you look at this
as a way of having something clearly cosmetic covered by your insurance.  You will benefit from the proposed surgery,
even if you are not 100% satisfied with the change.  In cases of this discrepancy in sag, more
than one procedure is often required to provide patients optimal results.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

From your photos, it appears you would benefit from both a reduction and lift on your right breast and then an augmentation on your left breast.  Things still won't be perfectly symmetric but they will be markedly improved.

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 plastic surgery.

best of luck!

Dr Schwartz

Gerald Minniti, MD, FACS · Answer

Hello,Wait on your surgery.  Your surgeon's idea of achieving a nice result is flawed.  Simply lifting your larger breast and placing an implant in the other will never look the same. One will be filled solely with natural tissue and be relatively loose within it's skin envelope, the other will be filled mostly with an implant surrounded by a thin layer of natural tissue in a tight skin envelope.The key to achieving the best symmetry is to equalize breast tissue and skin between the two breasts first. This is achieved for you with a small lift on the smaller breast, and a major reduction and lift on the larger breast. At that point your breasts will be equal in breast tissue content and skin envelope area, which will allow you to get equal sized implants placed in both. This can be done in one surgery.  You do have significant asymmetry, but you don't have to settle for a mediocre result. Best of luck!

Sheila S. Nazarian, MD · Answer

Your surgeon's recommended course of action is exactly what I would have suggested. And no, your symmetry won't be perfect. Frankly, no one's is. But I think you will be really happy with your results. Best of luck, Dr. Nazarian

Jeffrey A. Sweat, MD · Answer

First, congratulations on getting your surgery covered as many insurance plans would consider this to be a cosmetic issue and thus not covered.  Regarding your surgeon's plan, there are many different options for the correction of your asymmetry.  Certainly you need a lift of the larger breast and your scars will be very different as your breasts are starting very different.  Your concerns about one having an implant and the other not are valid, and you should discuss this with your surgeon.  However, there is no one right or wrong way in which to fix your problem and you will likely get many different opinions about how this should be corrected.  Best of luck with your surgery!

Charles Galanis, MD · Answer

I don't think you should assume asymmetry simply because one will have an implant and the other will not.  Of course no one can or should promise perfect symmetry but i think based on your photos that you can achieve a very good result with the proposed operation.  As much bad press as the VA system has received in recent years, I have personally been involved at time with the VA system and at least from the standpoint of plastic surgery, believe you can and should expect excellent care.  Discuss your concurs with your surgeon who should be able to show you some reassuring pics.  Good luck!

Martin Jugenburg, MD · Answer

Thank you for your question. No matter what, you will most likely always have some asymmetry due to the pre-existing differences in your breasts. Your surgeon should have some photos to demonstrate the outcome.All the best,

Donn M. Hickman, MD · Answer

It is not uncommon for breast asymmetry to require more than one operation.   I agree with right breast reduction with lift, and a small augmentation for the left breast.  Despite the effort to satisfy your desire for perfect symmetry, this is not always possible.  These are always challenging cases. The breasts can also change themselves over many years, such that the larger breast may increase in size with or without surgery. So, plan for one good surgery, and the chance of further refinements thereafter.

David S. Motoki, MD · Answer

Thank you for your questions and photos. Another potential treatment option would be to reduce the size of the larger breast and leave the smaller breast alone. This would eliminate the need for a breast implant on the smaller side. Both breasts then would be your own tissue. Breast implants are not permanent devices and commonly require replacement and revision surgeries. However if you want the smaller breast to be larger then a breast implant is necessary. You will still have some breast asymmetry regardless of what type of operation you settle upon. Discuss your concerns with the VA surgeon. If you are not comfortable with the plan then you would be looking at having the surgery done outside of the VA system and paying for it yourself. I hope it all works out well and you are pleased with the results.

Tracy E. McCall, MD · Answer

You will always have some degree of asymmetry. Everyone has some amount, yours will be a little more than most. The operation proposed is very reasonable. Doubly so since you are getting insurance coverage--most patients are paying for this very operation out of pocket at this time. I would recommend that you go ahead with the procedure. Understand that you will need to have things done in the future to keep the best long term result. Follow your doctor's instructions carefully. Do your best to maintain your weight. (I know that career military people have restrictions on this--that will be helpful for you.)Go for it. Good luck and thanks for your service.

I'm a veteran & I have been approved for a breast augmentation through that VA hospital. I have severe Breast asymmetry.(photo)

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