It is very noticeable B vs. DDD cup. I Am a Female with Pectus Excavatum and I Have a Breast Size Difference - What Can I Do?

it is very noticeable B vs. DDD cup and i have worn a silicone prosthesis for 5 years and i can't seem to find a doctor to do the surgery and my health plan wont help. either i feel inadequate as a young woman and want at least the breast asymmetry fixed help what can i do

Doctor Answers 13

Pectus Excavatun and Breast Asymmetry

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Several issues you raise in your question.  First, the chest wall pectus excavatum.  If you option to have this corrected, this usually entails a very involved procedure that will warrant the expertise of a thoracic surgeon.   With respect to your breast asymmetry, as my colleagues have stated, without a physicial exam, it is impossible to provide recommendations.  However,  the good news is that you likely have options to achieve better symmetry with several cosmetic breast techniques.   The third issue is insurance coverage.  It is unlikely that your insurance company will cover the breast surgery as it will likely be deemed cosmetic (as there is no functional defecit or cancer history).   However, it does not hurt to ask.  Please visit with a board certified plastic surgeon to learn more about your options. Best of luck. Dr. Basu

Pectus Excavatum and Breast Augmentation?

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Thank you for the question.

I think you may do well with a breast augmentation procedure on one side and a reduction on the other side. A variety of options are possible depending on your physical exam. Generally for patients with pectus excavatum I suggest sub muscular ( dual plane)  silicone gel breast implants.   I have found that,  for patients with pectus excavatum,  the use of different size and/or profile silicone gel implants greatly improve symmetry and helps to camouflage the pectus  excavatum.

You may find the link below helpful.

Pectus Excavatum, Breast asymmetry and insurance coverage.

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There are two issues here. One is the technical procedure and the second is the financial/insurance issues. I would also add that in addtion to the options mentioned here, the use of fat injection has provided another alternative to breast enlargement and partial pectus correction. When it comes to insurance issues, the physicians fee is only a portion of the bill and even if the professional fee werer waived, operating room, nursing staff, anesthesia , supplies and costs of implants will also need to be taken into account,

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast Asymmetry

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Without pictures, it is impossible to give you specific advice.  However, it is likely that your symmetry can be greatly improved with a combination of a reduction on the larger side and an implant on the smaller side.  You should be able to find some highly qualified, board-certified plastic surgeons in your area.  Good luck.

Pectus excavatum and breast asymmetry

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The breast asymmetry possibly can be fixed.  As for the pectus excavatum it is often a very involved procedure requiring a thoacic surgeon to reconstruct the chest wall.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Treatment of Breast Asymmetry in Pectus Excavatum

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Without a picture, it is hard to say exactly what you need. However, from your description, you need a reduction on the DDD side and probably an augmentation on the other (perhaps preceded with a tissue expander). While most consider this to be reconstructive, your insurance company may not pay for it. If they do allow it, it will have to be coded properly. If they do not cover it, you can still pay for it yourself.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Pectus excavatum with breast asymmetry

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The issues are significant breast asymmetry and the pectus excavatum (PE-a central indentation of the chest). Without a documented functional deficit such as cardiopulmonary compromise no surgical treatment for either issue would be covered by health insurance.

In milder cases of PE surgery on the breasts can mask the central indentation of the chest. This can be reduction, lifting and/or augmentation. In more severe cases the breast surgery will not mask or camouflage the indent. Without photos or preferably a face to face examination it is impossible to say what would be best in your case. If the PE is mild and the rib cage is not rotated breast surgery (some combination of reduction, augmentation and lifting) should probably be done first. Then if the indent is still visible you could have a pectus implant. Alternatively some of the breast fat on the DDD side might be shifted into the center of the chest to fill the indent. I was able to do this with a male pectus excavatum patient who also had gynecomastia.

If the pectus is more severe you should probably have the implant or shifting of breast tissue first and then come back for a second surgery to create more symmetric breasts. This is akin to working from the ground up.

In either case you will probably need a minimum of 2 operations to achieve an optimal result.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Pectus Excavatum

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You need a reduction on the DDD side and a reconstructive implant/expander on the B side. A photo would have been helpful. From MIAMI Dr. Darryl J. Blinski

Breast reduction for asymmetry

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Reduction of the larger breast is a good option when in a DDD-cup on the larger side. Though when considering the B-cup on the opposite side a breast implant becomes attractive to balance the result. You may consider an appeal to your health plan, or choose another if you can for we think coverage may be possible, at least based on the Chicago experience. Pectus repair with a solid implant may improve your chest contour and result, I am certain there is a good plastic surgeon in Orlando to help you.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast asymmetry and pectus deformity

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The correction that would be required could be as simple as implant placement to more complex procedures that may require several operations on both breasts. It is impossible to give you all the options without seeing you but a plastic surgeon should be able to go over all the options with you.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 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.