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Breast Asymmetry, Creating Balance

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Breast Asymmetry, Creating Balance
July 28
09:09 2016

Article Highlights

  • Breast asymmetry is exceptionally common
  • Sometimes, the way your spine is shaped will affect the way your torso is carried
  • When both breasts are quite droopy and one is larger than the other, the situation could be addressed by symmetric breast augmentation combined with a bilateral lift, which removes more tissue from the larger breast than from the smaller breast

It is widely believed that a well-proportioned, balanced face and body are closely linked to beauty and attractiveness. As human beings, we tend to gravitate towards the symmetrical over the asymmetrical, almost always. Given this predisposition, it seems logical that if you have – or acquire – a significant physical asymmetry, you may be eager to have it fixed.

“Breast asymmetry is exceptionally common,” said Dr. Robert Shenker, a plastic, cosmetic and reconstructive surgeon at The Cosmetic Surgery Clinic in Waterloo and Chief of Surgery at Cambridge Memorial Hospital. “There are no two breasts that are identical to each other. When you really examine them, you will always, always find a difference between the right breast and the left breast.”

Breast asymmetry can be congenital (a patient is born with it), developmental, with one or both breasts changing shape during puberty, or it can develop as a result of pregnancy and breastfeeding. Asymmetry can also result from surgeries or other medical interventions.

“For example, if a woman has a breast lump and has to have a biopsy, or has to have the lump removed,” said Dr. Shenker. “You take some tissue out of one breast, which makes it different from the other breast. So you could have a change in the size or a change of the shape, or you could have a scar, or an indentation on one breast that you don’t have on the other.”

Although most commonly associated with size, Dr. Shenker noted that breast asymmetry is often multi-faceted, involving noticeable differences in volume, position and shape. In some cases, the asymmetry may have little to do with any of these factors. Dr. Shenker gave the example of a patient who had scoliosis, which is a curvature of the spine, to explain.

“Sometimes, the way your spine is shaped will affect the way your torso is carried. You can have one breast look higher than the other, but it’s not really, it’s just the way that your whole torso has been twisted.”

Dr. Shenker added that there are patients whose ribcage might be more prominent on one side than the other, which can make one of the breasts look bigger than the other.

“The actual breast itself isn’t different, but the foundation that the breast is sitting on is different from right to left.”

As breast asymmetry can take a number of different shapes and forms, there are numerous correction procedures available, depending on what a patient requires. Dr. David Ward, co-founder and a plastic surgeon at Valley Cosmetic Surgery Associates Inc. in Surrey, BC and medical director at the Valley Surgery Centre, said that in situations where both breasts are small and asymmetric, for example, “it may simply be a question of placing a larger implant on the smaller side.”

“Rarely, in the case of very large asymmetric breasts, the patient may experience more shoulder or back symptoms on the side of the larger breast,” expanded Dr. Ward. “Such a situation would indicate bilateral breast reduction, wherein more tissue is removed from the larger side to create symmetry.” Potential risks associated with a lift or reduction are wound healing problems and poor quality scars, which can “significantly detract from the esthetics of a balanced breast size and breast position.”

Dr. Ward also mentioned that sometimes breast shape or nipple position could indicate the need for an additional procedure, such as a breast lift, which could be performed on both breasts or only one, and it can be done alone or in conjunction with breast augmentation.

“When both breasts are quite droopy and one is larger than the other, the situation could be addressed by symmetric breast augmentation combined with a bilateral lift, which removes more tissue from the larger breast than from the smaller breast,” elaborated Dr. Ward. “The end result would be breasts with symmetric volume, a lifted position and more fullness overall – as a result of the combination of procedures selected.”

Dr. Ward added that the solution can be relatively simple as a suction assisted lipectomy (removal of fatty tissue) for a larger breast or autologous fat transplantation (fat grafting) to the smaller one.

“Rarely, the solution is a unilateral implant.”

When implants are used to treat breast asymmetry, Dr. Ward stated that the risks are the same as when implants are used with symmetrical breasts.

A patient must consider the possibility of such complications as “implant rupture, capsular contracture, sensory changes, infection, hematoma, re-operation, poor scarring and implant removal.”

Downtime for breast asymmetry correction procedures varies. Dr. Ward noted that the recovery could be as short as a week for a straightforward asymmetric breast augmentation and as long as three weeks for more complicated procedure(s).

Keeping this in mind, patients who undergo breast asymmetry correction surgery generally benefit substantially from the procedure.

“The obvious benefit is a more esthetically pleasing chest, but beyond that, most patients experience enhanced self-esteem and confidence. Clothing fit improves,” confirmed Dr. Ward. “In the candidate for asymmetric reduction, symptoms related to breast weight, such as neck and shoulder pain, may be alleviated.”

Although breast asymmetry correction is valuable for those who seek it, not everyone is equally as anxious to get it done. Dr. Shenker mentioned that some patients are more affected by breast asymmetry than others.

“Let’s say a patient breastfed a baby more on one side than the other, and she has a little bit more skin laxity on one side than on the other side as a result. Oftentimes, she won’t even notice her asymmetry until I point it out to her,” asserted Dr. Shenker. “And she will say, ‘Oh! I never really ever noticed that!’ She may say, ‘Well, should we try to fix it? Or should we ignore it?’ And together we will make a decision. Some patients aren’t upset about their asymmetry.”

However, this esthetic imbalance can take quite a toll on others. Moreover, these patients are often determined to have it fixed.

“Younger patients with congenital or developmental asymmetries are often very distressed,” said Dr. Shenker. “Patients who have had breast cancer, which may involve a mastectomy or radiation, are often very emotionally affected. For many of these patients, correcting their asymmetry is also about recovering from their disease. It’s part of their cancer cure in their mind, so for them, it’s very important.”

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