Complicated anatomy. How many surgeries? (Photo)

I recently did a virtual consultation aND the surgeon let me know I have challenging anatomy and referred me to Baylor Medical for multiple surgeries. I want to get a feel of how many and what kind of surgeries for a ball park feel before I start going to lots of doctors. I just want to know what may be my options. Photos attached. 5'3" just recently lost 50lbs. About 36B with different size of each breast.

Doctor Answers 9

Breast surgery with asymmetries

Your asymmetries are challenging.  But with good techniques. I think a acceptable outcome is achievable.  It is important to accept that you will not have "perfect symmetry".  It is impossible for any patient.  More so when you have significant asymmetries.   Your "wish" photos need to be carefully reviewed with your chosen PS to establish realistic expectations of your anatomy.  

Please make an in-person consultation with a ABPS board certified PS to evaluate you and discuss your options.
Hope that helps and best wishes!
Dr. Morales
ABPS Board Certified
Houston, Tx


Houston Plastic Surgeon
5.0 out of 5 stars 25 reviews

Complicated anatomy. How many surgeries?

Hello dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively.By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, hugs!

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 361 reviews

Breast asymmetry

Dear mrt0928:

I think you can get a good result with just one procedure.   Although a formal physical exam is needed to give you any meaningful advice, based on your photos alone, I do see you have a breast asymmetry. (Remember, asymmetries in the breast are quite common - so you are not alone)  In addition, it appears you may have a constricted breast (where the nipple to fold crease distance may be tight).   A one stage procedure will give you a very nice result.   In the worst case scenario, you may need a small secondary procedure to fine tune your result.  I would likely recommend a breast augmentation with a periareolar approach and a periareolar mastopexy.  The limited scar periareolar mastopexy will allow me to reshape your breast.  In addition, it will allow me to perform a "radial release" to relax/open up the "constriction" that may be present.  All this can be safely done in a 2-2.5 hour outpatient surgery.   Please visit with a board certified plastic surgeon well versed in managing breast asymmetries for a formal consultation.   Best wishes,

Dr. Basu
Houston, TX

One stage or two for breast aug and lift

Thank you for your question. From your pictures there is asymmetry in size, constriction of the lower pole of both breasts, and different nipple positions. There are many plastic surgeons that would perform your surgery in a single stage and many that would perform it with two stages. I can't think of a reason for more than two procedures. Although I wouldn't call your anatomy simple, I think "complicated" is an exaggeration. Your breast shape is not unusual and can be treated reliably. Best of luck!

Complicated anatomy. How many surgeries?

Judging by the photos there is a size and shape asymmetry which is fairly common and if you look on this site you will see different degrees of asymmetry some worse than yours some not.  At the very least should have a breast augmentation with different sized implants to address the volume difference.  There is a difference in nipple position but it does not appear to be that significant in the photos and requires a scar at least all around the areola to address it.  I would wait on that since you may be happy with the way things look after the breast augmentation alone.  I would at least see 2 -3 other plastic surgeons, since the one you saw does not seem to be comfortable with your case.  Best of luck.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 53 reviews

Weight loss breast asymmetry breat augmentation

I see your concerns. Looking at your photos your asymmetric breast can be corrected. Your left breast appears to have a "constricted base" meaning Elysium breast on the left is more narrow. This is the why you have been told your augmentation maybe difficult. We would like to widen the left breast, left and then augment the breast. The right breast will need a standard lift and augmentation. Your surgery should include an extension of the incision laterally to help remove the excess skin under your arms. 
 You are going to look fabulous. Remember to see an experienced board certified plastic surgeon for all your concerns. I wish you well

Challenging anatomy

Without being able to exam you there are options to choose from which will all require you to compromise.  These may be shaping with a Lift or possibly just some positioning of an implant with a nipple lift.

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 33 reviews

How many surgeries?

It is impossible to predict how many procedures any patient will require because we just don't know how tissue will respond to surgery and if any complications will arise. Nothing can substitute an in office consultation with a board certified plastic surgeon who can help achieve your goals. Best of luck, MMT

Tuberous breast

You likely have a component of tuberous breast, or at least A constricted lower pole. So, most PS will attempt to get your surgery done all at once, but with the understanding that you might need a little touch up afterwards. Meaning, 90% of the problem will be dealt with and if there's anything left that's not perfect at the end, it could need a revision. I'd Want to do some lipo and fat grafting to the breasts at the same time to help fill out and decrease chance for double bubble. Win-win

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.