Young (18) but Uneven Breasts

I'm 18 and am about 200 pounds (sadly). I've always had uneven breasts and I've learned to live with it but I've had enough of hiding it. I'm young and I should feel confident. I hate bra shopping and it's always been very emotional for me to deal with this. My left breast is about a small A cup while my right one is about a full B cup. I'm wondering how much the cost would be also if it is possible to get them even and how could my areolas be relatively the same size?

Doctor Answers 15

Breast asymmetry in an 18 year old. PHOTOS

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In my opinion, you would need a lift and reduction on the right to roughly make them equal. Subsequent to this youcould udnergo bilateral augmentation with implants (saline due to your age) or consider fat grafting for a  subtle but autogenous tissue augmentaiton without implants. This may take more than one session.

Breast asymmetry

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Certainly you are a candidate for surgery.  I would probably recommend an implant on the left and either a lift alone or a lift and small implant on the right.  The areola can also be reduced at the same time. Now, realize that not only are no two breasts the same before surgery, as you can see in your case, they will not look the same afterward, but should alot  be better.

Breast asymmetry

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Breast asymmetry is very common and surgical correction is possible. In my view, a correction for you is actually a reconstructive procedure due to a congenital discrepancy in your breasts. Some insurance companies cover this type of reconstructive breast surgery. The correction often requires more than one operation. The areolar sizing is definitely correctable. I recommend that you seek a Board Certified Plastic Surgeon in your area with a lot of experience with breast reconstruction.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Uneven breast correction

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First, let's clarify that breast asymmetry is extremely common and ultimately correctable in large part.  The result is typically very acceptable but not perfect.  You will notice that there is a severe asymmetry of the nipple areola complex as well.  Both sides will need an implant.  The left side is essentially a reconstruction with a larger implant.  The right side is corrected by using a smaller implant and making the areola smaller.  This will require several incisions on the right breast which will be evident.  I think correcting this deformity will give you more confidence and motivate you to loose some of the weight that concerns you and launch you into a new phase of your life.

Wishing you the best,

Tal Raine MD

Marked breast asymmetry in a fully grown woman

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This is a significant breast asymmetry but I would recommend against trying to get it covered by insurance as you will lose control and choices over what is the best approach. It shouldn't cost $20,000 but it likely will require at least two procedures as it is quite difficult to balance volume, position, and shape differences at the same time. It will also change in the future depending on weight changes, pregnancy effects, and aging. 

Think of this as custom breast surgery rather than a set operation. The other is to consider all the short term and long term issues and consider which breast is the better shape and position. If you want to truly balance the two sides as much as possible and control for future changes, I would recommend lifting and reducing the right breast to match the shape, volume, and areola size of the left. This evens out the breast tissue volume and position which will help minimize asymmetry in the future. If you want to increase the size of the left, then I would recommend augmenting both breasts with equal implants after the right side has been lifted and reduced and allowed to heal and settle. It's possible to do the two procedures at the same time but it's very difficult to judge the effect of the implant volume and change the shape, position, and volume of the right side at the same time. 

The other approach would be to augment the left breast to try to match the volume of the right and then at a second procedure adjust the right side to match the left. This is the more common approach but would almost certainly result in future asymmetry due to weight, pregnancy effects, and age which would then need further surgery to restore symmetry. 

The goal in either case is not perfect symmetry but to try to get the two sides within the normal degree of difference between breasts such that you don't have to deal with it and people will not notice the difference if it's within the normal degree of difference between breasts. Perfect symmetry is not a realistic goal. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Uneven breasts are more common than you might think, and fixable!

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It is so apparent how much this has bothered you for years. I completely understand that you want your breasts to look more even, so you can just be confident with your body.  You should first know that you are not alone--this is actually a very common thing!  Second, it is fixable.  You can expect good results after the initial surgery, but you should also expect to need touchups (revisions) for final great results.  In addition, you may choose to have an implant as part of your breast surgery, and that would lead to more surgeries years later.

You have several options.  First, you might consider lifting the right breast and using an implant for the left breast enlargement.  Revisions here would likely include a touchup on the lifted breast as you continue to age and skin changes. You can expect more size match than shape match with this option.

Or you might consider breast lifting with fat grafting to both sides.  This would give you the benefit of having no implant to fuss over as time passes, and you'd have some fat removed from another area that you didn't want it.  This would still require more than one surgery, though, as you may need some external tissue expansion to get a better initial result on that left side.

Have several consults with members of the American Society of Plastic Surgery (please don't see a "cosmetic surgeon", just a plastic surgeon!).  Good luck!

The surgical correction is possible but will require more than one urgery

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You have breasts that are  very different in size and shape. Implants only correct the size mismatch and mastopexy correct the shape differences. If you get implant for the left and mastopexy for the right,your breast will age an sag different and in few  years you will have very different breasts again.

 I would recommend  bilateral mastopexy and fat grafting to even out the shape and the size for the first stage. If you desire bigger breast the second stage will require implants for the enlargement 3-6 months after. 

As you see there are very different treatment plans . The reason for this inconsistency is the complexity of your condition. Please get few consultation and chose a surgeon that you are comfortable with her or his treatment plan.

Breast Asymmetry in teenagers

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This is a relatively common problem but can be corrected. Each specific correction will, however, require a careful evaluation of all the differences between the two breasts with specific treatment designed to correct each. Sometimes a simple augmentation of the smaller and reduction of the other areola and lift of the opposite breast is all that is required. Sometimes the muscle will require reconstruction or the smaller side will require skin stretch. The only way to determine what you need and the cost is with a full consultation with an experienced Plastic Surgeon.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Congenital Breast Deformity

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Dear Anon,

The condition that you have is a congenital breast deformity.  Of course, the condition was not present at birth since your breasts aren't present at birth.  However, the condition is programmed into your breast genes.  Some insurance companies will cover this type of breast correction.  Check with your insurance carrier if you have health insurance.  The correction can be complicated and might require a lift on your right breast and possibly tissue expansion on your left breast to enlarge it.  Consultation with a plastic surgeon will answer your questions and assist your insurance claim.  Good luck!

Breast asymmetry

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Breast asymmetry is a very common problem for a lot of women. In your case this is compounded with asymmetry with involves both size and shape. I would also point out that you also have a tuberous or constricted breast deformity which needs to be corrected. There are numerous different ways your case could be done. I would recommend a combination periaeolar augmentation and mastopexy which will address both the size and shape issues. Make sure to visit with several doctors and spend time looking at their before and after pictures with examples of cases like yours.

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.