Q: Dr. Eppley, I am a 28 year-old female who has been considering breast enlargement for a long time. My right breast is significantly smaller than my left breast and I have never been comfortable with them being so lopsided. I am pretty sure that I want this procedure done but I am a bit nervous about how they will be made more even. I don’t want to larger breasts that are just as lopsided. How would you go about making my breasts more even?
A: Congenital or developmental breast asymmetry is one of the most challenging problems in breast augmentation. This is because the two breasts are not different in just mound size but also in the amount of overlying skin and in the position and size of the nipple-areolar complex. While implants are an integral part of this ‘reconstructive’breast augmentation, consideration must be given to adjustment of the nipple position as well as a possible staged approach using a tissue expander if the asymmetry is severe enough.
The key phrase here is ‘making your breasts more even’ or decreasing the magnitude of the breast asymmetry. Perfect breast symmetry is not possible in these cases and one has to be prepared for a higher risk of the need for revisional surgery to try and achieve the best result. Breast implants alone, while making the breasts bigger, often unmask or reveal the many differences between the two sides in breast asymmetry.
Dr. Barry Eppley