Which Insicion Type is Best for Asymmetric Breasts?

My right breast i slightly bigger than the left and left nipple faces down. One surgeon advised me to do a BA with mastopexy thorugh aerola for 12000. Another surgeon told me she'll fix it through the brest crease for 7500. The assymetry is not severe. What should I do??

Doctor Answers 17

Which Insicion Type is Best for Asymmetric Breasts?

Which Insicion Type is Best for Asymmetric Breasts? Incisions around the areola (periareolar, circumareolar, circumvertical and/or horizontal) will allow the greatest versatility for correctiing breast asymmetry

Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Incision for breasts

You may need a third opinion to figure out why the two are so different in thought process.  I could not say without seeing photos or performing an exam.  Good luck.


Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Incisions for repair of breast asymmetry

Always hard to make an appropriate recommendation without seeing you in person.  It sounds by your description that it may be difficult to address the difference in areolar size and other issues with just an IMF incision.

Good idea to go to a few Board Certified Plastic Surgeons and clearly state your goals, (bringing in photos helps as well).  He will be able to tell you if these goals are realistic depending on your individual body type.  See before and after photos.  Price, while an issue, should not be the main issue.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Treatment of breast asymmetry

Breast asymmetry is a complex problem, not just for the immediate future, but for the long term future.

Great experience is necessary in deciding a game plan for you. 

I would advise consulting with several experienced board certified plastic surgeons and get their imput.

Often, because of the complexity of the problem of asymmetric breasts, doctors have different solutions to the problem.  Remember always to ask for the best solution, and try not to "tie your doctor's hands" by specifying how the surgery should be performed.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Breast asymmetry and breast incisions

First of all, it is important to remember that some breast asymmetry is normal- everyone has at least a little bit..  You will find that different surgeons are comfortable with different approaches- it does not necessarily mean one is right and one is wrong.  I tend to utilize an incision in the inframammary crease when placing implants, as this has a lower rate of problematic capsular contracture than the incision around the nipple.  

The crease incision also has less problems with deforming the areola and nipple numbness.  if a lift needs to be performed, I make a second incision at the nipple that does not communicate with the implant- this keeps the risks of long term capsular contracture low, but allows precise lifting for symmetry improvement.  Remember that an incision in the crease below your breasts tends to scar very well and is not visible unless someone is looking under your breast- standing or sitting, it's like there is no incision at all!

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 56 reviews

Augmentation in the asymmetric breast can shift incision placement

Breast augmentation incisions, around the nipple, under the breast, under the arm, all involve personal preferences, lifestyle, breast shape, clothing choice, implant choices, etc. All of us have individual ideas of what may be best or what might 'show'. When there is asymmetry however there may be compromise. For example one fold may be higher and need to be pushed lower. The nipple also may be uneven and lower on one side and not be corrected by the implant alone. In this situation a lift such as a round block on one breast may make the periareolar incision the correct choice on the opposite breast. If you do have one nipple pointing downward the periareolar incision, or around the nipple is the best choice. Even if you do not choose to have a lift on the drooping side at the time of your breast augmentation, it is likely that you will want the nipple lifted at a later date.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Breast asymetry

Pictures are needed to determine what procedure that you need. With your description of the left breast a Mastopexy is needed, that the other side needs a lesser procedure based on what your first doctor said does not mean that you would use  the same incision. The goal is to try and achieve relative breast symmetry  and if one breast needed a smaller incision that is a good thing. 

Walter D. Gracia, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 3 reviews

Improving breast asymmetry involves more than decision about incision placement

Most breasts are a little bit asymmetrical but when it is noticeable enough to require surgical correction, the best operation will depend entirely on what the nature of the problem is. There are volume differences, differences in the location of the inframammary fold (bottom edge of the breast), nipple location (too high, too low, too far to the side or too close to the middle), differences in the shape of the rib cage, and so on. If it is purely a size difference, then it won't matter where the incision is, it's just a matter of implant sizes. If the nipple location is an issue, it cannot be corrected with an inframammary incision alone. One procedure that is sometimes helpful in cases of asymmetry is using expander implants (Spectrum from Mentor).

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

The incision ddoesn't matter!

Now, why do I start of by saying that?  Well, if you don't make the right diagnosis the incision won't matter because the incision alone will not fix the problem.

If the nipple appears to point down because the crease is very high and tight compared to the other side you may have a form of tuberous breast deformity.  In that case releasing the crease and doing ssome internal work may improve the problem significantly.  This is especially true if the nipples are at the same height from a fixed point like the notch at the top of the sternum.

If the creases are relatively the same, the nipples point down and they are at different heights you may need a mastopexy of some type to correct this problem.

So there is no best incision for the coreection only make a correct diagnosis of the problem so it can be fixed using any number of incisions or techniques.  Good luck.

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 6 reviews

Insicion type is best for asymmetric breasts

What should you do - POST photos!!! We really can not answer you expertly. But my guess is you need a staged operation or at least 2 operations.

Best of luck from MIAMI DR. B

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 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.