Corrective surgery for very asymmetrical breasts? (Photo)

Hi, I am 18 and have had uneven breasts my whole life. I talked to my obgyn about it today and she recommends surgery and referred me and said its about a 2 cup difference. I am wondering what my options are. I was looking into fat grafting and that seemed to be perfect for me. However I'm not sure if that could be done with my difference. I would like to do the option with the least recovery time and as little scaring and pain as possible. Please let me know what you think I should do.

Doctor Answers 15

Corrective surgery for very asymmetrical breasts?

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You have what's called a "hypoplastic" breast on the left. It's not just an "asymmetry"; it failed to develop normally.  The disproportionality is so great that a carefully staged procedure would probably be required.  In order to better control the stretching of your skin that will be required, a tissue expander may be placed on the left.  This device is filled in the office at intervals to slowly stretch the breast pocket where an implant will go. Fat grafting may not be optimal for you for the following reason: fat only survives when it has space to "live", and the space on the left is very tight.  As well the fold of the left breast needs to be adjusted to match the right and to increase the distance between the fold and the nipple areola complex.  Finally, you may need a small lift on the right side to improve the symmetry even after the implant is in on the left.  Though your breasts will never be completely symmetric (no one's breasts ever are), an improvement in the appearance of your breasts is absolutely possible.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast Asymmetry

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You could certainly try fat grafting. It would need to be done two or perhaps three times and you need donor sites to get the fat from.  The quickest result would come from an implant an possibly a lift.  Your nipple areolar complex on the left seems to be on the same trajectory as your left so simply putting an implant in might do it.  It would be best to get a few different opinions.  You will be closer in cup size for sure with an implant or fat grafting, (if you have enough donor sites) the real issue will be making you symmetrical as possible in terms of looks. 

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Severe breast asymmetry

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Breast asymmetry is not uncommon, and no 2 breasts are perfectly symmetric.  Breasts are sisters, they are not twins. But in your case the reconstruction will be a little complicated.  In my opinion, i would try to match the left breast to the beautiful right breast.  First a tissue expander in the submammary position on the left, and then a final implant (two operations in about a 3 month time period).

Malcolm A. Lesavoy, MD
Beverly Hills Plastic Surgeon
3.9 out of 5 stars 11 reviews

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I would recommend considering an augmentation for your small breast and a breast reduction and lift for your larger side. This can be a tricky procedure to get correct, so seek an experienced plastic surgeon in your area.

Congenital breast defect correction

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Thank you for your question and picture.  I would seek out experienced board certified plastic surgeons who do both reconstructive and aesthetic surgery as this asymmetry correction can be more invlolved.  There are many options for you and this will be explained during an in person consultation based on your goals and desires. Best of luck. 

Corrective surgery for asymmetric breasts

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Hi, Iarebba.  I am glad to hear that you are considering reconstructive surgery for yourself.  The good news is that you have a lot of options to choose from, depending on what your goals are and what is more important to you.  Just having normal looking breasts is important for most women's sexual identity.  Having nicely shaped breast with adequate volume and perkiness can also increase their confidence and self- esteem.  Fat transfers is the most natural option (and one of my favorite) but you can usually only increase the volume one cup size per transfer procedure.  That will not be enough for your case because as you have pointed out your other breast is at least 2 cup sizes larger.  You can elect to have multiple fat transfer sessions to gradually get you more than one cup size but that gets more expensive and time consuming.  Also without being able to examine you, I don't know if you have enough fat to transfer.  Also if your breast skin and tissues are tight it will be more difficult get more fat in there.  It would make achieving symmetry easier if you were willing to have a breast lift and/ or reduction of the larger/ saggier breast.  It would leave more scars on the breast but you will not have to transfer as much fat to the other breast.  Probably the simplest option, though, is to place an implant in on the small side and do a lift for the larger breast for symmetry as it will be difficult to try to match a contralateral naturally saggy breast with just an implant alone for the small side.  You have a challenging case, but this is the type of case that a lot of plastic surgeons including myself love to take on as it can really have a positive impact on the patient's well- being.  I would definitely recommend you see a few board certified plastic surgeons who have a lot of experience treating similar cases (and a lot of experience with breast fat transfers if you are thinking that route), and choose someone you feel comfortable with.  Best wishes.

Very asymmetrical breasts

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Thank you for your question.  First of all you will need to accept the fact that you will need at least two operations to achieve a result that you will be happy with over the long term.  You are looking at some combination of reducing/lifting the larger breast and augmenting the smaller breast.  Just making your breasts the same size will not do you any good if they look totally different which is what will happen if your surgeon puts in two different sized implants and does nothing else. This is because the smaller breast with the large implant will end up high and very tight while the larger breast with the smaller implant will stay more or less where it is.   In my opinion what should be done is to lift and reduce the larger breast to get it to look as close in size and shape to the smaller breast then come back later for a breast augmentation.  Depending on the level of the fold on the smaller side and the distance from the nipple to the fold it may also be a good idea to lift that breast to position the nipple slightly higher.  If you do it this way then you will end up with implants that are closer in size, if not the same size, and a result that will be more symmetrical over time.  Fat grafting might be an option but it would take at least two procedures to augment your smaller breast to the size of the other one.  One possibility would be to do liposuction on the larger side to harvest the fat to put on the smaller side.  In order for that to work, though, the larger breast would have to be mostly fatty tissue and not firm, dense breast tissue which is often the case in younger patients. Make sure you see a plastic surgeon who has experience with this kind of problem and can show you pictures of THEIR results in similar patients.

Lars Enevoldsen, MD
Modesto Plastic Surgeon
4.6 out of 5 stars 28 reviews

Corrective surgery for breast asymmetry

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Thank you for your photo and question.  I think breast augmentation with an implant will give you a nice improvement.  I would not recommend fat grafting.  See some Board Certified Plastic Surgeons in your area who perform Breast Augmentation for free in person consultation. Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 52 reviews

Asymmetric Breasts

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Hello,Fat grafting is a possibility, however you would need to use a Brava Bra system to expand you tissues, including the skin below your breast to recruit as part of your larger breast.  Additionally, you would need more than one fat grafting session.   Alternatively and implant could be used.  Regardless, some additional surgery will be needed on the opposite side, based on your physical exam. Go visit a few ABPS certified/ASAPS member surgeons that specialize in breast surgery.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Corrective surgery for very asymmetrical breasts?

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Asymmetry to the degree shown in your photo is correctable but complicated and usually requires 2-3 surgeries over a year. Fat grafting will not even come close and would be a waste of your money. See 2-3 very experienced surgeons for an exam and to develop a plan. The end results will be very nice, it just takes time to get there. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

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