While most women have some asymmetry between their breasts, for a few this is more pronounced with a difference in either the volume and shape of their breasts. They may describe their breast as tubular breasts (tuberous breasts deformity), small (hypoplasia), or that they just have a weird shape. Women may be able to camouflage these asymmetries by wearing padded bras or loose fitting clothing. However, this is not always possible and many feel self-conscious and even embarrassed to seek help with their concerns.
Young girls in their adolescence are often most affected by breast asymmetry, as the asymmetry becomes noticeable during puberty when the breast enlarge. This is an important time when relationships with peers, perceptions of sexuality and identify are established. While optimal results are achieved after full breast development has occurred, it is possible to intervene earlier in selected cases to improve symmetry of the breasts to assist them during this turbulent period.
With the latest advances in cosmetic breast surgery it is possible to have natural looking, symmetrical breasts that enhances your self-esteem and compliments your body shape. However it must be highlighted that breast asymmetry correction is a challenging procedure that requires an experienced Specialist Plastic Surgeon, who can offer the vast array of techniques required, such as:
Breast augmentation with breast implants
A breast implant can be positioned on the smaller breast to improve breast volume and improve overall breast symmetry. If a women would like the overall breats to be bigger on both sides, than we have the option of either using different sized breast implants to create symmetry, or the preferred method is using the same sized breast implant on both sides and performing a breast lift or reduction on the larger side or both to give the best result in terms of volume and shape.
A breast reduction may be performed only on the larger breast in order to match smaller breast in shape and volume. However, if they desire both breasts to be small overall, we can perform a breast reduction on both sides, with customisation of amount of breast tissue removal to achieve breast symmetry.
In women with one breast that is slightly larger, often with the nipple / areolar lower than the contralateral breast (frequently after breastfeeding), than a breast lift on one side only is frequently performed. However most commonly, especially in patients with tuberous breast anomaly we perform a breast lift combined with a breast implant, plus the addition of fat grafting to improve both breast volume and shape.
Breast tissue modification
In women with severe the breast asymmetry we often need to modify the breast glandular tissue to allow the breast implant to expand a often tight or constricted breast. This has historically been done by cutting and reshaping the breast tissue – glandular scoring with excellent results. However using the latest fat grafting techniques, we can expand the deficient aspects of the breast tissue by carefully using your body’s own fat tissue and re-injecting it into the breast tissue at the same time as we perform the breast implant surgery. If the breast asymmetry is extremely, to give a more reliable and safe outcome we may elect to stage the breast reconstruction by using a breast tissue expander prior to performing the final breast implant surgery.
TUBEROUS BREASTS DEFORMITY
Tuberous breast anomaly or deformity has had many names, including constricted breast, tubular breast deformity, snoopy breast, herniated areolar complex, and lower pole breast hypoplasia. Many patients do not know they have tuberous breast deformity, having lived their lives thinking their breasts are not quite right. They don’t realize how common this condition is, and there are many effective surgical techniques available to correct and restore a natural breast shape.
Tuberous breast deformity has a wide range of severity and is defined by conditions such as the following:
• A breast that is small or underdeveloped
• High or tight inframammary fold
• Deficiency of skin in the lower half of the breast
• A large areola with herniation of breast tissue
• Droopy breast with nipples sitting low or downwards pointing
CORRECTION OF TUBEROUS BREASTS
Correction of tuberous breast deformity is one of the most challenging aspects of cosmetic and reconstructive breast surgery and often requires multi-staged surgery by a Specialist Plastic Surgeon to get the optimal result desired.
• In mild cases of tuberous breast anomaly, a breast augmentation with an anatomical breast implant can solve the problem and restore a natural breast shape. As the breast is constricted or tight in the lower pole of the breast, scoring of the breast gland is often performed to releasing the tight breast tissue to allow the implant to fill and expand the lower aspect of the breast. A mastopexy or breast lift, may be required at the same time as the breast augmentation to correct the breast herniation and enlarged areola at the same time.
• In more severe cases of tuberous breast anomaly, when the patient has little breast skin / volume, a staged procedure may be required with a tissue expander that recruits extra tissue along with selective scoring of the tight breast tissue during the initial procedure. In the second procedure a permanent implant and mastopexy is performed.
One of the biggest advances in the correction of tuberous breast anomaly has been the addition of fat grafting. The ability to combine fat grafting to enhance and restore the volume deficiency of the breast, especially in the lower aspect of the breast with a breast augmentation has allowed a much more natural breast shape to be created. Utilising the latest fat grafting techniques with the BodyJet Evo – ‘water assisted’ liposuction technique has allowed greater fat graft survival with improved cosmetic outcomes.
Women with Poland’s Syndrome have very obvious asymmetry in their chest wall with significant under development of the breast on the affected side. Poland’s Syndrome has a wide spectrum of abnormalities that affect the chest wall and upper limbs, in addition to the underdeveloped breast these may include:
• Absence of the pectoralis major muscles
• High nipple position or even absence of nipple
• Narrow chest width on the affected side
• Absent ribs or sternum
• Finger and hand abnormalities on the affected side
While mild cases can be treated with a breast augmentation procedure alone. In more severe cases, extensive reconstruction is necessary. The options include tissue expander with breast implant, fat grafting, latissimus muscle reconstruction or transverse rectus myocutaneous (TRAM) flap reconstruction.
RIB CAGE ABNORMALITIES
In women with significant rib cage abnormalities, they can present with breast asymmetry. If the ribs are deficient or very prominent, this in turn can affect the size and projection of the breast, such that in women with a prominent rib on one side can have a breast that appears much larger, and vice versa.
This is a very common variation that needs to be identified during your consultation as women may not be aware of her rib asymmetry and it has implications in the selection of your implants and the final results of any breast augmentation procedure.
Breast hypoplasia is due to lack of development of the breast during puberty; characteristically the breast is either absent or very small. This is the most common form of breast asymmetry and is usually corrected by breast augmentation of the affected side. However may women seek augmentation of both sides by using different sized implants to gain fuller, more natural looking breasts to complement their body shape.