Breast Asymmetry

It is actually natural and normal to have some degree of asymmetry between the breasts. However in some circumstances, excessive asymmetry is present. This can be corrected through surgery which results in a normalised appearance. There are a few methods which can be used by your surgeon to create symmetry between your breasts.

• A breast augmentation can be performed on the smaller breast to match the size of the larger breast.
• The larger breast can be reduced via breast reduction surgery or alternatively breast liposuction to match the smaller breast
• The insertion of implants of different sizes in both breasts to create symmetry between the breasts.
• Performing a breast lift with or without implants for one or both breasts
  Your surgery will need to be individualised according to the cause and degree of the problem.

Causes of Breast Asymmetry

Breast Asymmetry is often congenital (present at birth), but may not be obvious until puberty and breast development. There are many causes for uneven breast development, some more common than others.

Breast Hypoplasia

This is a descriptive term for total absence or deficiencies in breast development. Characteristically, the breast is either absent or small overall. This is the most common form of breast asymmetry and is usually corrected by implant augmentation of the affected side.

Tuberous Breast Deformity

This can occur on one side (unilateral) only or on both sides (bilateral). Tuberous breast deformity has the following characteristics:

• asymmetry in size
• deficiency of breast volume in the lower part of the breast
• large areola and nipple on the affected breast
• ‘tube’ like breast shape, with narrow base and long projection
• droopy breast with nipples sitting low or pointing downwards

Correction of tuberous breast deformity can be challenging, and various techniques can be used depending on the severity of each feature. Most commonly, augmentation with expander or implant, concurrent breast lift, areola reduction, or breast scoring is used to restore a more normal appearance to the breast. Often, multi-staged surgery is required to get the optimal result.

Poland’s Syndrome

Children and adolescents with Poland’s Syndrome show a spectrum of abnormalities of the chest wall. However, characteristics associated with underdeveloped breast may include:

• absence of chest wall muscles – such as pectoralis major, latissimus dorsi and others
• high nipple position or even absence of nipple
• narrow chest width on the affected side
• absent bony structures of the chest wall
• finger and hand abnormalities on the affected side

Depending on the severity and number of under developed structures, different techniques are used to correct the contour and shape of the chest wall. Latissimus dorsi flap and implants are the most common methods of reconstruction for these young girls.

Rib-Cage Abnormalities

It is not uncommon for children or adolescents with rib-cage abnormalities to present for correction of their breast shape and size. These abnormalities are often misdiagnosed as underdeveloped breasts when in actual fact, their breasts are normal, but appear small because of the sunken chest wall. Chest wall deformities can be unilateral or bilateral. Two main types are described:

• Pectus Carinatum – when the breast bone protrude between the breasts
• Pectus Excavatum – when the breast bone and ribs sink deep towards the back

If these abnormalities are mild enough, simple breast augmentation with implants are adequate to correct the shape and volume. However, if the abnormalities are severe, a referral to the thoracic surgeon should be sought to discuss the options in correcting chest wall shape. Breast impants in the latter cases often result in disappointing cosmetic outcomes.

When is the right time for corrective surgery?

Young girls in their adolescence are often most affected by breast asymmetry. It is a fragile period during which self-esteem, self-confidence and self-identity is established. Even though most optimal result is achieved when full breast development has been reached, each case is assessed on individual basis. Adjustable implants can be used so that the implant can be inflated with sterile saline injection (through a port under the skin) to keep up with breast development of the normal breast until maturity is reached, at which time, the port can either be removed, or the implant can be changed over to something more suitable.

Obviously future revisions will be required as weight fluctuations, pregnancies, breast-feeding and aging change the appearance of the natural breast as well as the corrected breast. Life-long monitoring of the implant is also essential to verify its integrity.

Cost of Breast Asymmetry Correction

Correction of breast asymmetry should be covered under private health insurance. However, check your policy carefully for any exclusion in plastic surgery, breast surgery, breast implants and pre-existing conditions. If you are covered, approval from the medicare board may still be necessary before any claims can be made to your fund. If you have any queries, please do not hesitate to discuss your concerns with our staff.