Mass media depictions of cosmetic surgery often impact negatively on public perception of the specialty. Aesthetic procedures can work miracles: not only genuinely lead to remarkable physical improvements, but also revive one's self-esteem and confidence which are even more important. We should not be too judgmental about cosmetic surgery, but accept that modern medicine can improve quality of life and make us feel better, not simply treat illnesses. In my practice, patients who have undergone successful cosmetic intervention are among the most satisfied and grateful patients I have had the privilege to treat.
Many parts of our body are asymmetrical. Breast asymmetry is particularly common so no wonder that many women are aware of a slight difference in the shape and/or size between two sides. In most cases this is mild and no intervention is required at all. More noticeable differences (for example, at least one bra cup size discrepancy) or completely different shapes between two breasts often justify corrective surgery.
Condition is almost always entirely benign and predominantly of cosmetic and psychological concerns. Surgical correction of breast asymmetry has shown to have immensely positive impact on women’s wellbeing, confidence and self-esteem. It is often carried out following breast cancer treatment.
It is almost impossible to find even two similar patients. Clinical presentations are highly variable (as illustrated in Gallery below) and so are the surgical options and reconstructive combinations. Sometimes only one side can be treated to achieve more balanced look; other times both sides have to be addressed. Operations are planned as per patient preferences and roughly guided by basic surgical principles.
Stable results are common in adult women whose breasts are no longer growing. In younger ladies whose breast are still enlarging, postoperative changes are likely and it should be clear that additional adjustments might be likely in the future and are often an integral part of staged treatment. In many cases, it is not possible to achieve absolute symmetry between two sides, but major improvements are possible and often a norm. The aim of surgery is improvement rather than perfection!
Breast asymmetry can be treated by variety of means. Choices are highly individual and few operations might be required in order to achieve good ultimate symmetry. The commonest options, used alone or in combination, are:
- Breast Enlargement (Augmentation) – performed on the smaller breast, increasing its tissue size and making it similar to the other side
- Breast Reduction – performed to reduce the larger of the two breasts so to match the smaller breast as accurately as possible
- Breast Uplift (mastopexy) – often accompanies above two procedures – it raises the nipple to the higher position and tightens the glandular tissues within the breast improving shape and projection of the breast rather than changing the volume and size
- Expander Augmentation – this is a safe and elegant technique whereby a temporary, inflatable implant is inserted on the smaller side first. Volume of the expander is gradually increased by injecting the saline through a tiny valve and tube connected with an implant. This is done in outpatient’s room. Expander will stretch the soft tissues and is left in for about a year or so. Once breast is expanded to the desired volume, the second operation is performed when the temporary expander is exchanged for the permanent silicone implant of the corresponding size. This method has the advantage that an accurate size match between the two breasts can often be achieved. The silicone implant that replaces the saline expander has a softer, more natural feel, which is why many women choose to have the expander replaced. Alternatively, the valve can be removed and the expander can be left in place, acting as a permanent implant, without having to be replaced
The decision on which procedure to undergo to correct breast asymmetry is something that needs to be carefully discussed at the time of your consultation. Deciding to balance the size or shape of your breasts is a very personal matter, and ultimately only you can decide if it is right for you. My role is to assist your decision, guide you through various options and explain what is realistically possible against your preferences.
Unfortunately, complications can occur following any surgery and patients need to be fully aware of this. I always tend to carry out surgery in a safe manner and take all sensible, precautionary measures to minimise risks and complication rate.
Symmetrising breast surgery is associated with same risks that apply to breast enlargement / reduction / uplift surgery (described in separate sections). Those rae briefly listed below:
- Bleeding and haematoma (including need to return to theatre to evacuate large blood clot in approximately 3-4% of patients)
- Infection (3% of patients)
- Delayed wound healing
- Widened or hypertrophic scars
- Fat necrosis
- Skin numbness
- Nipple necrosis
- Alteration in nipple sensation, size and position (minor adjustments can be made at a later time)
- Asymmetry (minor adjustments can be made at a later time)
- Clots in the legs/lungs
Once again, patient should be patient and realistic. Perfectly symmetric breast are a rarity even on non-operated, attractive female chest so sensible expectations are essential. Nevertheless, above operations, carried out sensibly and competently, often lead to miraculous improvements.
Examples in the gallery below illustrate what can be expected and realistically achieved.
Urgent concern after your surgery ?
Please ring the hospital where you have been operated on or my secretary and they will get in touch with me