How best to fix breast asymmetry after weight loss? Major constriction on one breast. (Photo)

I have asymmetrical breasts (32 B and full C), with the left being constricted, or tubular. The nipples are the same size and shape and in the same location. I've lost 85lbs (from 217 to 132, at 5'5") and maintained it, and am ready to tackle this issue. I scar badly and would prefer not to do a lift if possible, unless it's my best chance at symmetry. I like the the shape of the right breast, but want implants to fill and correct. My skin is thinner, but still relatively elastic. Suggestions?

Doctor Answers 11

Fix Assymetry After Weight Loss?

Good work on that weight loss.....................but often it comes with few negatives which we can help you address. Photos taken with your arms raised are actually not optimal because they elevate your breast and make it difficult to determine if a lift is needed. All that said, it does not appear that you will need a lift and that you don't truly have a constricted breast on the left, or if so, it is mild.

So your "fix" would likely involve augmentation with different size/profile implants to correct your asymmetry. One of the challenges for your situation will depend on your degree of skin laxity. It might be the case that you will need a larger implant on the right side to fill out your skin. This would mean that you would need an even larger implant on the left to correct your asymmetry. So it might be the case that your asymmetry will be reduced but not eliminated, or that a small lift on your right side would be helpful to tighten the skin. Ultimately an in person consultation will be needed to answer these questions.


Asymmetry

Hello,

Thank you for your question. You may not need a lift if breast ptosis and nipple position is not too low. You will need to be examined in person to know for sure. Release of constriction could be done for one side along with a BA if needed and two different sized implants could be placed as well if tissue asymmetry is enough. An in-person consultation with a board certified Plastic Surgeon will give you the opportunity to explain your aesthetic goals and concerns, then learn about your options.

All the best

When breasts are asymmetric...

congratulations on your weight loss!   It is always good to hear when someone is able to overcome their weigh tissues.  If you have retained fat anywhere and you just wanted better symmetry, fat grafting would be recommended.  If you want to be larger, then you're going to need implants and save the lift for later if you're not as even as you thought you were when your implants are settled.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast Augmentation After Weight Loss

Congratulations on the weight loss and thanks for adding your photos, that is helpful. From what can be seen, it appears that you simply have asymmetry without any constriction. As a result, a breast augmentation using different size implants should correct your size difference and give you a very nice result. This is especially true is you opt to have shaped gummy bear implants that would help with giving you an optimum result without a lift.

I have added a video for you to learn more about these breast implants as well as a web reference.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 58 reviews

Breast lift and augmentation combinations #plasticsurgery

I believe your best opportunity for good breast shaping and improved symmetry is to consider a lift with small reduction on your larger side and sub muscular augmentation on both sides - perhaps with differentially sized implants. An in-person examination is required to make these decisions and we're in Seattle, close to you.

How best to fix breast asymmetry after weight loss?

Thank you for the question and photos. You would do well with breast augmentation using different size implants and a possible short scar lift on the right side. Without an in person physical examination and measurements it is difficult to state what type of implants you need, placement of implants and skin elasticity/laxity. See a board certified plastic surgeon for an in person consultation . Good luck.

Fixing your breasts

The photos with the arms up are not beneficial in planning but nothing in the pictures you posted shows major constriction or tuberous deformity. It looks like a properly done breast augmentation with asymmetric implants and crease adjustment on the smaller side could do very well for you and that you could hold off on a lift until you see what the implants alone can do for you. Congratulations on your weight loss!

How best to fix breast asymmetry after weight loss? Major constriction on one breast.

Thank you for your pictures and questions. Congrats on your weight loss. I appreciate your effort in sending pictures, but I do think that the position of your arms for taking the pictures does amplify the asymmetry. It would be helpful to see a picture of you from the front with your arms at your side. Despite that, I do see what you note with the asymmetry. I do not see any evidence of "constriction" of your left breast and I would disagree with you when you say that you have a tubular breast. What you do have is less soft tissue on that side and the biggest difference I see is the differing position of the infra-mammary fold. 

I would advise you to have consultations with some local board certified plastic surgeons to get multiple opinions on how to get you to your goals. I think that you have a good chance of correcting not only the volume difference with implants, but with proper placement of the implants, you can change the position of the IMF on the left to more closely match that on the right. I would not pursue a lift at this time, but I do think that there is a possibility of you needing a small procedure after the augmentation to correct any nipple asymmetry that results if you are really looking to fine tune the outcome, but I do not think a formal lift will be required. 

Best of luck!

How best to fix breast asymmetry after weight loss?

Thanks for the question. Asymmetry to some degree exists in all patients, but there are surgical options to reduce the asymmetry. To give the most thorough analysis to your situation we would need good photos, which means level front and both side views with your arms relaxed at your sides, any other view exaggerates or hides issues.
But you clearly do not have what we call a tuberous or constricted breast deformity. Before determining what surgical options might help we would need to know your goals, ie both breasts like the small one, both breasts like the big one, or both breast different from their current size and shape. There may be some combination of lifts or lift and reduction or augmentation so lots of choices. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Would be reasonable to initiate treatment with breast augmentation

Thank you for the photos.  They are a good effort on your behalf to provide details of your situation but are limited in interpretation as the "selfies" usually position the arms in positions that exaggerate asymmetries.  Nevertheless, your photos provide a good deal of information.  I do not see any evidence of base constriction.  Your asymmetry is does show some difference in the vertical positions of the nipples.  I suspect an augmentation alone may adequately manage the volume disparity, however the nipple positional differences are  less predictable.  If the magnitude of your asymmetry on examination does not exceed what is visible these photos, I would recommend a breast augmentation and "save" the breast lift for scenarios where the outcome is less than expected.  Good luck in your endeavors!

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 17 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.