Uneven and Lopsided Breasts. What Are My Options?

I am 22 years old. When I was 8, I suffered a gash on the underside of my left breast that required 12 stitches. The wound eventually formed a large keloid. As a result, that breast was never able to grow properly, and is about three sizes smaller than my right (normal) breast, which is a 36C. Also, my normal breast is very saggy. What exactly would the surgical procedure include if I want to make both my breasts even and of the same size, and reduce the sagging.

Doctor Answers 6

Breast Asymmetry

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First it is very difficult to address any issue of asymmetry without a picture.  The issue is what I describe a the vertical skin envelope.  This refers to the measurement from your collar bone, across your nipple to the fold beneath your breast.  If a lift is performed on the 36 C side, this would shorten that vertical envelope making it easier to match.  This would be excluding your scar as it sounds as though it needs to be revised.  Than comparing that measurement to the breast you like.  Assuming you are comfortable with the 36C this will determine how much extra skin is required to match that side and then the second issue how much volume in the form of an implant.  If it is a limited amount of skin there are several options.  One may be a tissue expander to stretch out the skin and then come back to place the implant as a second stage, a second option would be to tunnel below the fold and move some of the upper abdominal tissue onto your breast termed, a Ryan Advancement Flap.  Pictures and measurements would help to determine what your best options may be.  

Bethesda Plastic Surgeon

Uneven and Lopsided Breasts

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It is really hard to give anything but the most generic answer to this problem without photos. The size and shape difference alone are a significant challenge to the surgeon, but add to that a tendency to keloid scarring makes it still tougher.


The smaller breast, unless it is a satisfactory size will need to be enlarged, almost certainly with an implant. If it also sags, a lift might be needed. For the "normal" breast, the minimum procedure would be a breast lift, though a breast reduction may be more likely to give and even appearance. An implant may be in order if you wish to enlarge both sides.

Best approach would be to see a plastic surgeon in your community, and review you options. If you seek more that one consultation, which is a good idea, be prepared for the possibility of different approaches which may be hard to sort out!

Thanks and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Uneven Breasts

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Obviously, your situation is complicated and should be evaluated in consultation with a plastic surgeon who can examine you.  Based on your description, however, I do have a couple of things to suggest based on patients I have had with a similar problem.  First, it sounds like you need a breast lift on your "normal" side.  It is also possible that, if your "abnormal" side was the same volume as your normal side, it might need a breast lift as well.  Again, this is something that needs direct examination in order to give you an accurate assessment.  You could also add a breast implant to your abnormal side to make it the same volume as your normal side or you could add different volume implants to both sides if you want to be larger overall.  While I don't know of any formula to determine the volume difference between your normal side and your abnormal side, you have flexibility in adjusting the volume of saline implants during surgery that you don't have with silicone gel implants (which come pre-filled).  I also use inexpensive, disposable "sizers" that I can fill with saline or air during surgery to help me determine the volume difference before I open an expensive implant.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Breast augmentation or reduction, and a breast lift

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Asymmetry is definitely the norm for women. One breast is always different in shape or size than the other. The only problem is when the asymmetry is very apparent, which could cause embarrassment for the woman affected. You can get breast augmentation or a reduction surgery to balance out your breasts, and a breast lift for both breasts.

Uneven and Lopsided Breasts. What Are My Options?

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You will find that online consultants, without the benefit of posted photographs or in person consultation, will not be able to provide you with precise enough advice to be truly helpful. There are a variety of different ways to handle breast asymmetry concerns depending on physical examination findings and the patient's specific goals. You may find the attached link, dedicated to breast asymmetry concerns, helpful to you as you learn more about these options. When the time is right, seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients in your situation achieve the goals they are looking for. Always best to achieve a long-term stable weight prior to undergoing elective breast surgery. Best wishes.

Need a photo

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Certainly we can't tell you "exactly" what you need without even a photo or an in person exam.  Best to visit the best plastic surgeons in your area for thoughts on your very complicated situation.

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.