Is there any other solution besides Implants

Question

i'm a 19 yr old girl,for as long as i can remember i have been unhappy with my breasts. it is my biggest insecurity.My breast are quite uneven to where my right breast is much larger than my left. i feel like i have slightly tuberous breast as well although i have never had that confirmed medically. Also my Areolas are quite large and puffy ( the right areola is larger and almost points downward). i'm not quite sure why they do this. i'm a 36 B and i am quite happy with the size of my breast but am very unhappy with the shape and uneveness of my breast as well as my areolas.for personal reasons i would like to avoid getting implants if at all possible but i would still like to improve my breast. i have noticed something called "Natural Breast Augmentation" or "Fat Transfer to Breast" and am highly interested in it, would a procedure like this change the shape of my breast into more of a rounded shape to look more normal? and could this be combined with a Areola Reduction? or would my best option just be to get the breast implants?

Kenneth Hughes, MD · Answer

Implants can certainly be avoided in cases of breast asymmetry.  The larger breast can be reduced, while lifting both breasts.

Gary M. Horndeski, MD · Answer

The optimal solution for you is a new technique called The Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reduce the size of your areolas, reshape your breast, elevate them higher on the chest wall and move them more medial to increase cleavage.  At the same time, your larger breast can be reduced for a more accurate match.  This technique avoids implants, there are no vertical incisions and the results are natural.  I do not recommend fat injection because it is still experimental.  The Mini Ultimate Breast Lift is an all natural procedure with no foreign bodies and no injections.

	Best Wishes,

	Gary Horndeski, M.D.

Richard G. Schwartz, MD · Answer

Judging from your photo, it seems you do have a variation of tuberous breast deformity, which is often accompanied by a significant difference in size between the two breasts. The standard approach usually includes various types of breast lifts to lift and reshape both breasts, sometimes a different technique for each breast. The areolae can be reduced, lifted, and centered nicely within each breast. If you like the size of your smaller breast, then the other one can be reduced to match, and no implants are necessary. If, however, you want one breast enlarged to match the other, then you must have a breast implant placed unless you choose to have a series of fat grafting procedures. This process is still evolving at present, and the number of doctors enlarging breasts via fat grafting is still relatively small. Of course, if you want both breasts enlarged, then you need to consider either implants or fat grafting for both.

James E. Chappell, MD · Answer

Thank you for the photo and the history you provided. Yes, you have tuberous breasts with significant asymmetry. This is something I see regularly. You will first need an in-person consultation with a BC PS and surgically probably breast lifts (both sides) and either a small implant on the smaller breast or a reduction of the larger breast, depending on which breast size you want to match. Best of luck to you.

Eric Swanson, MD · Answer

Yes, you do have quite severe asymmetry. First, you need bilateral vertical breast lifts. I almost never do it on just one side because the result will look better and more symmetrical if the procedure is done on both sides (so your areolar borders match - it is impossible to match the natural fade-out of a nonoperated areola). Secondly, I would recommend simultaneous implants (you can have saline implants) to help round out your breasts and restore upper pole fullness that you will like and should have, particularly at 19 years old. I find my best results in correcting asymmetry come from doing both procedures in combination (having all my tools at my disposal). Never mind "natural" breast augmentation or fat transfer - you are likely to be disappointed with these options. I've attached a link so you can view results in women with asymmetry (check out patients R.Z. and N.B.) You can change your breasts from a source of self-consciousness to a source of pride!

Antoine A. Hallak, MD, FACS · Answer

from the pictures it looks like you do have uneven tuberous breasts. the treatment for that condition can be a combination of lift and areolar reduction and volume equalization whether by implant or fat transfer. I personally prefer implants but you need to consult with a qualified plastic surgeon and get well informed about your options.

Rian A. Maercks, MD · Answer

Your concerns are valid but the answer is complicated.  I have treated breasts like yoursin both ways with great results.  I love using fat transfer and it is possible to get good symmetry this way but it has to be done right and with artistry.  You will also need a breast lift/areolar reduction at the same time.  remember there are all kinds of practitioners out there so do your homework and find a surgeon that you relate to and that understands your desires and expectations.  I hope this helps.

	 

	All the best,

	 

	Rian A. Maercks M.D.

Jeffrey Zwiren, MD · Answer

You have significant differences in the size and shape of your breasts. The goal is to make you evener and less asymmetric, absolute symmetry is most likely not possible. If you are happy with your breast volume on the right side then a bilateral breast lift would be the right operation. If you want a larger volume then you would need different sizes of implants with a larger wider implant on the right. The key is to center the implant behind the center of the nipple and reduce the diameter of your areola.

Norman Bakshandeh Day, MD, FACS · Answer

you have asymmetry that is more accentuated than most women. your left breast is about 20% larger with a wider areola. i think you would benefit most from a lift especially for the left side. I am not a fan of fat transfer for this problem.

Kenneth R. Francis, MD, FACS · Answer

Dear FL,

	You do indeed have a form of tuberous breast deformity.  I presume that the photo is taken in a mirror, which would explain why you are stating that your right breast is larger and more sagging when we are seeing it as your left breast.  You can improve the shape of both breasts with a lift operation limiting the scars to just around the areolae (with perhaps a small vertical scar needed on the right, larger breast).  Your choices with that would be to; 1. leave the volumes asymmetric, 2. reduce the right breast volume to match the left, 3. symmetrize the volumes with different sized implants placed in both breasts, 4. symmetrize the volumes with a single implant placed in the left breast, 5. symmetrize the volumes with fat transfer, either simultaneous with the lift or at a later time in a staged fashion.  Your condition is complicated and the choices numerous.  Be sure that you are in the hands of an American Board of Plastic Surgery certified plastic surgeon.  Good Luck!

Is there any other solution besides Implants

Answers (12)

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