Questions about breast asymmetry correction (Photo)

Your breasts are asymmetrical in volume, shape and position. The large lower breast needs to be lifted using The Bellesoma Method. This will reshape your breast tissue creating more upper pole fullness without an implant, elevate it higher on the chest wall and more medial to increase your cleavage. Vertical scar is avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, it is possible to perform a mini lift on the smaller breast. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. Fat transfers can be performed to match the larger breast.

Best Wishes,

Gary Horndeski, M.D.

Dear Okli76,
based on your photos, it looks like you have severe asymmetry. You will get good results with fat transfer and breast lift. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your question and for providing photographs. Breast asymmetry is a common yet challenging surgical concern and one that can not be treated with shortcuts. I do believe that fat transfer to your left breast is a good option for correcting the volume discrepancy. The fat can be harvested from multiple areas including your abdomen/flanks, thighs, or back. My preference is thighs and abdomen/flanks. About 50% of the fat transferred should take if done correctly. Because this is a moving target one option is to stage these procedures and address the right breast once the final volume of the left breast is reached at around 2-3 months. A periareolar mastopexy for the right breast is a poor option in my opinion because of these reasons, it tends to flatten the breast and it does not hold up well over time. The scar and areola will widen leaving most patients unhappy.
If you are happy with the nipple position on the left my advised plan would be to perform fat transfer to the left breast and a vertical lift (lollipop incision) of the right breast with possible small volume reduction to match. If you are willing to stage these surgeries that would be ideal but I understand most patients would like to accomplish this in one stage which is a fine option as long as you understand the rationale for discussing a staged surgery.

A simpler option for you would be to reduce the larger breast through liposuction. Just a few tiny incisions. It won’t give perfect symmetry but it will be an improvement and probably work better than fat transfer

Fat grafting would be a good solution for the smaller breast .
The larger breast could be reduced with lipo suction and the nipple elevated with a circum-areolar lift
See my web site for further information

You can do fat transfer to the smaller breasts and fat can be taken from several areas if donor fat is available. You can also consider minimally invasive skin tightening with radiofrequency, like Renuvion, for tightening and lifting your skin with minimal scars.

Your proposed plan sounds like a good one.
Delivering consistent quality, Liposuction and transfer result is more difficult than most people realize. The number of plastic surgeons who have mastered these procedures are in a small minority. Provider selection, power mode and patients should not assume that most plastic surgeon can do these procedures well.
For that reason, I recommend any patient considering Liposuction instead of transfer of multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patient with similar characteristics to your own. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures they’ve actually done. When it comes to fat transfer results, recognize the early results can look very impressive, but do not in any way represent final results. Always confirm the timeframe of when after pictures were taken in relationship to the date of surgery. After pictures should always be taken a minimum of three months from the date of surgery, but preferably, six months or longer.
Bring pictures of your own body to use as a reference during consultations. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. That can be harvested from any part of your body and the ideal candidate for fat transfer should be a good candidate for Liposuction and a good candidate for fat transfer. Do not overlook vetting the providers for the Liposuction skills. Poorly done Liposuction can leave people disfigured, and I’ve seen this multiple times from breast fat transfer, or patients were not focused enough vetting providers for Liposuction skills.
There’s no correct number of consultations needed to find the right provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Considering how much variation there is a Liposuction and fat transfer skill I recommend starting the process by having at least five consultations before scheduling surgery.
Patient candidacy, and provider selection are generally the two most important variables, so understanding, and focusing your efforts on these two variables is generally at the heart of getting quality outcomes without regret.Best,
Mats Hagstrom, MD