BA options for terrible asymmetry and a tuberous breast? (Photo)

Hello! I am 26, no kids. I have always had severe breast asymmetry and after researching, I realize that my right breast is definitely tuberous. I am interested in doing a breast augmentation to have larger breasts, but I also know that I will have to correct the tuberous breast and I have seen some cases where a lift is required because of the asymmetry, so just looking for some opinions on what kind of surgery I would have to do!

Doctor Answers 9

Breast asymmetry

All breasts are different left to right before and after any surgery, especially without clothing. To make your breasts more symmetrical would require different sized implants with reduction/lift/reshaping of both sides. Since you have not had children yet, you may want to do this in stages- one option would be implant to the smaller side only for now. If you are not planning any pregnancies for some time, you could do both sides. You still may require a touch up such as fat grafting in the future.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. 

Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Correcting breast asymmetry

It is natural to have asymmetrical breasts - in fact, it’s the norm! To achieve better symmetry, you have a few options. In addition to correcting your tuberous right breast, your options include:
a breast lift to make your breasts perkier
a breast lift combined with implants for perkier and larger breasts
a breast reduction and lift in the larger breast to match the size of the smaller one

You should know that if you plan on having children in the future, the results of your breast lift may be negatively affected.

Leila Kasrai, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 66 reviews

Breast asymmetry

There are many different ways to handle the two different breasts depending upon your goals. This can combine augmentation with lift techniques, and even reduction techniques for the larger breasts. An exam in person is essential.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The key to your surgery will be to release the inferior pole  constriction bands.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 123 reviews

Dr Kayser

Thank you for your question. You are clearly accurate in your description of your breast condition which can be one of the more challenging approaches to restore. There are differences in your breast volume which would require either an implant, a breast reduction, or even the use of fat transfer to alter and improve volume symmetry. There are also differences in the position of the nipple which would require a breast lift on the lower or droopy breasts to achieve correction as well.

The biggest concern is really related to the tuberous or constricted breast where the nipple to fold distance that is short. This does require expansion and is typically accomplished with the placement of an implant and surgically releasing some of the internal constriction bands. Most often, however, this would result in what is referred to as a double bubble where are the outline of the implant and the original fold still remain. Newer approaches such as external expansion using BRAVA domes with fat transfer and scar release has been effective in many of my patients. I would certainly encourage you to seek out a consultation with a board certified plastic surgeon who is experienced in these matters. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 37 reviews

BA options for terrible asymmetry and a tuberous breast?

Thank you for your question and photo.  Breast augmentation with implants would be the first step in attempt to improve breast symmetry and shape.  During the course of breast augmentation and attempts will be made to release the constrictions of the inferior pole of the right breast.  I would not start with subareolar skin resection as the implant may adequately expand the constriction.  It is likely that she will need a second revision operation to achieve the best result.  Whether the second operation involves fat transfer or further release of your constriction will depend upon the preference of the board certified plastic surgeon you choose.

Fat Transfer for Breast Augmentation

Thank you for your question and photos. in my practice I typically use fat transfer to address concerns such as yours. It may require multiple transfers, but it can provide exceptional results. The link below will give you more information and show you results from a patient similar to you.

Sarah A. Mess, MD
Columbia Plastic Surgeon
4.7 out of 5 stars 21 reviews

Breast augmentation options for terrible asymmetry and a tuberous breast?

Thank you for the question and pictures.

Yes, I think your breasts do demonstrate some of the qualities seen with tuberous (constricted) breasts; there is a wide range when it comes to tuberous/constricted breast presentation.

Generally speaking, some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy” areola and some degree of ptosis (drooping). 

Generally, correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

 In your case, if the appearance/shape/size/asymmetry of the breasts are a concern, you may be an excellent candidate for corrective surgery.

When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery.

I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Breast augmentation for asymmetry and tuberous breasts?

To see before and after photos of women similar to you who had straightforward breast augmentation under the muscle, with different size implants (saline) to correct their asymmetry, click on the link below. Hope this information is reassuring. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths." Good luck to you. 

Ted Eisenberg, DO, FACOS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 78 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.