Breast Asymmetry Correction

What is Breast asymmetry correction?

Breast asymmetry correction surgery is a procedure that improves the differences between the breasts if these are noticeable. Minor differences between your breasts is normal, but if these differences are larger then the size, shape or position of one or both of the breasts can be changed to make the breasts more equal.
Depending on the amount of difference between your breasts and your individual breast characteristics there are a few options – these include making the smaller breast bigger (breast augmentation), making the larger breast smaller (breast reduction), making both breasts bigger or smaller, or lifting a drooping breast into a more normal position (breast lift).

What will it do?

Breast asymmetry correction surgery involves changing the size, shape or position of one of both the breasts to make the breasts more equal. This may involve surgery to make one or both of the breasts bigger, smaller or less droopy. Further changes in your breasts are likely to occur over time and further surgery is likely to be necessary to maintain symmetry between the breasts.

Is it right for me?

Breast asymmetry correction surgery is a highly individualised procedure and may not be suitable for everyone. Always talk to your Specialist Plastic Surgeon before making a decision. Your Specialist Plastic Surgeon will assess your condition and general health, and plan the treatment that is best suited to you.

Before you decide on breast asymmetry correction surgery, there are some important issues to keep in mind:

  • Breast asymmetry correction surgery will improve the differences between your breasts at the time of the surgery - however further changes are likely to occur with time in your breasts, especially if the difference is large, and further surgery to maintain breast symmetry is likely to be required
  • Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants
  • Although breasts of any size can be lifted, the results may not be as long-lasting in women with heavier breasts
  • Surgeons generally recommend waiting until breast development, child birth and breastfeeding have stopped before undertaking breast asymmetry correction surgery – however if the difference is large then the surgery may need to be performed when young
  • Smokers are at increased risk of complications from any surgery. If you are serious about undergoing cosmetic surgery, you should try to quit smoking
  • If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives to cosmetic surgery. These may include other treatments, wearing padded bras or accepting yourself the way you are.

A breast asymmetry correction may be a good option for you if:

  • You are physically healthy
  • You have realistic expectations
  • Your breasts are fully developed
  • Your breasts are significantly different in size (especially if more than one cup size difference)
  • Your breasts are significantly different in shape i.e. one is sagging and has lost its shape and firmness compared to the other breast
  • One breast is lower than the other

Remember that the shape and size of your breasts before surgery will influence the surgical procedure and the outcome.

Will I need anaesthesia?

Yes, breast asymmetry correction surgery requires either general or local anaesthesia. Modern anaesthesia is safe and effective, but does have some risks. Ask your Specialist Plastic Surgeon and anaesthetist for more information.
Your surgeon and/or anaesthetist will ask you about all the medications you are taking or have taken, and any allergies you may have. Make sure you have an up to date list before the surgery.

What are the potential risks and complications?

Modern surgery is generally safe but does have the potential for risks and complications to occur.

Some possible complications and risks associated with breast asymmetry correction surgery may include:

  • Surgical risks such as bleeding or infection
  • Fluid accumulation around the operation site(s)
  • Visible and prominent scars including keloid and hypertrophic scars. These are raised, red and thickened scars that may form over the healed incisions. They may be itchy, annoying and unsightly but are not a threat to health
  • Allergic reaction to suture materials, tape adhesive or other medical materials and lotions
  • Skin discoloration, permanent pigmentation changes, swelling and bruising
  • Fatty tissue deep in the skin could die (fat necrosis) leaving hard lumps
  • Changes in breast and nipple sensation
  • Temporary or permanent areas of numbness
  • Wrinkling of the skin over the implant
  • Keloid, or lumpy scar tissue, which is pink, raised and irregularly shaped. These scars may be inflamed and itchy. There are several possible sites for the incision. Discuss this with your surgeon
  • Capsular contracture, where firm scar tissue forms around the implant causing it to lose shape and softness
  • Inappropriate implant size
  • Implant rupture or deflation
  • Asymmetry (unevenness) of the breasts
  • Calcium deposits in the scar capsule around the implant
  • Granulomas, or lumps in local lymph node tissue formed by leaking silicone
  • Breastfeeding difficulties, including reduced milk supply
  • Reduced effectiveness of breast cancer screening, since an implant may hide breast tissue (and tumours) during a mammogram
  • Movement of the implants from their original position
  • Potential partial or total loss of nipple and areola
  • Need for further surgery to treat complications
  • Risks of anaesthesia including allergic reaction or potentially fatal cardiovascular complications such as heart attack
  • A blood clot in the deep veins of the legs (deep vein thrombosis), which can move to the lungs (pulmonary embolus) or to the brain and may be life threatening
What are some other issues associated with implants that I should consider?

There have been allegations that implants are linked to the development of connective-tissue diseases such as rheumatoid arthritis, lupus erythematosus, scleroderma and similar auto-immune conditions. While some research has suggested small increased risks, many medical studies have not shown that the implants increase the risk of these problems. A proportion of all women in the community will develop these diseases, including women with implants.. The possibility of the development of connective-tissue and auto-immune diseases, even if remote, should be considered.
Rarely, women with implants have reported general symptoms, including joint pain, general aching, swollen lymph glands, unusual tiredness, greater frequency of colds and flu, hair loss, rash, headaches, poor memory, nausea, muscle weakness, irritable bowel syndrome and fever. The relationship of these symptoms to autoimmune disorders has been suggested but not proven.

Will breast asymmetry correction interfere with breast cancer detection?

Implants may interfere with the detection of breast cancer using mammography, a type of X-ray examination. If you have had breast cancer, a family history of breast cancer or may have other risk factors for breast cancer, tell you Specialist Plastic Surgeon.
There is no evidence that breast implants increase the risk of breast cancer, although the possibility has been considered. It is important that you learn to self-examine your breasts for lumps, in addition to having any regular tests that are recommended by your doctor. Your surgeon may also suggest a regular follow-u

Will breast asymmetry correction affect my ability to breastfeed?

Individual cases may vary but generally, mothers can breastfeed after having breast asymmetry correction. However, some women do experience reduced nipple sensation following breast asymmetry surgery making it difficult to trigger the milk let down reflex. Some women may also experience reduced milk supply. If you are planning to breastfeed after breast asymmetry correction surgery, talk to your Specialist Plastic Surgeon to get the latest information on this issue.

What is the Breast Implant Registry?

The Breast Implant Registry (BIR) is a public health initiative focusing on patient safety. The Registry collects relevant patient, surgeon, procedural and implant data relating to breast implants. Choosing to become part of the BIR allows patients to be contacted should there be any concerns regarding breast implants. The Registry is administered by the Australian Society of Plastic Surgeons Inc (ASPS).

Where will the surgery take place?

Depending upon your general health and the extent of the procedure, breast asymmetry correction surgery can be performed either as a day case or alternatively with a short hospital stay. Your Specialist Plastic Surgeon will advise on the best option for you.

What do I need to do before the surgery?

Before undergoing surgery, it is important that you:

  • Be as fit as possible to help the recovery process
  • Reach your optimal weight
  • Check with your surgeon about your medications as some may need to be stopped
  • Stop smoking

You will also be asked to provide a complete medical history for your Specialist Plastic Surgeon including any health problems you have had, any medication you are taking or have taken, and any allergies you may have.
You may be advised to stop taking certain medicines such as non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, and medicines that contain aspirin. You may also be asked to stop taking naturopathic substances such as garlic, ginkgo, ginseng and St John’s Wort as they may affect clotting and anaesthesia. Always tell your surgeon EVERYTHING you are taking.
You may be given medicines to take before the surgery, such as antibiotics.
Your surgeon will also advise you if any other tests are required, such as blood tests, X-ray examinations or an Electrocardiograph (ECG) to assess your heart.
Prepare a “recovery area” in your home. This may include pillows, ice packs, a thermometer and a telephone within easy reach. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic. Someone should also stay with you for at least 24 hours after you return home.
Your surgeon should give detailed preoperative instructions. Follow them carefully.

What do I need to do after the surgery?

Following your surgery, dressings or bandages may be applied to your incisions. You may be wrapped in an elastic bandage or a supportive garment to minimize swelling and to support your operation site as it heals. A small, thin tube may also be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will need to take at least a few days off work to rest. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports until advised by your surgeon.

If you experience any of the following symptoms, notify your surgeon immediate:

  • Temperature higher than 38°C or chills
  • Heavy bleeding from the incisions
  • Worsening redness around the incision sites
  • Increasing pain or tenderness, or other problems that appear to be worsening

Your surgeon will give you specific instructions on post-operative care. These instructions may include:

  • How to care for your surgical site(s) following surgery
  • Medications to apply or take orally to aid healing and reduce the risk of infection
  • Specific concerns to look for at the surgical site(s) or in your general health
  • When to follow-up with your surgeon

Be sure to ask your surgeon specific questions about what you can expect during your individual recovery period, such as:

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? If so, when will they be removed?
  • Are stitches removed? When will they be removed?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?
Will I have scaring?

Scars are an inevitable part of any invasive surgery. Your Specialist Plastic Surgeon will endeavour to minimise scarring and to keep your scars as inconspicuous as possible. Most of the scars are hidden in the crease underneath the breast but there but there will always be a scar visible around the areola following a breast lift. Scars may fade with time and become barely noticeable over time.

Will I need revisional surgery?

This is unusual initially. However, as with all surgical procedures, revisional surgery may occasionally be necessary. Implants do not last for ever and revisional surgery because of implants should be expected at some stage. Further changes are likely to occur with time in your breasts, especially if the initial difference is large, and further surgery to maintain breast symmetry is likely to be required.

What are the costs associated with this procedure?

Cost is always a consideration in elective surgery. Prices for individual procedures can vary widely between Specialist Plastic Surgeons. Some factors that may influence the cost include the surgeon’s experience, the type of procedure used and the geographic location of the office.

Costs associated with the procedure may include:

  • Surgeon’s fee
  • Hospital or surgical facility costs
  • Anaesthesia fees
  • Prescriptions for medication
  • Post-surgery garments
  • Medical tests

Your surgeon should welcome any questions you may have regarding fees.

Words you should know

Areola:
Pigmented skin surrounding the nipple

Augmentation mammoplasty:
Breast enlargement by surgery
Breast Augmentation:
Also known as augmentation mammoplasty; breast enlargement by surgery

Breast Implants:
Medical devices placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants can be filled with either salt water (saline) or silicone (elastic gel)

Capsular contracture:
A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm
General anaesthesia:
Drugs and/or gases used during an operation to relieve pain and alter consciousness
Haematoma:
Blood pooling beneath the skin
Inframammary incision:
An incision made in the fold under the breast
Intravenous sedation:
Sedatives administered by injection into a vein to help you relax
Local anaesthesia:
A drug injected directly to the site of an incision during an operation to relieve pain

Mammogram:
An x-ray image of the breast<
Mastectomy:
The removal of breast tissue, typically to rid the body of cancer
MRI: Magnetic Resonance Imaging:
a painless test to view tissue similar to an x-ray
Periareolar incision:
An incision made at the edge of the areola
Saline implants
: Breast implants filled with salt water
Silicone implants:
Breast implants filled with an elastic gel
Submammary or subglandular placement:
Breast implants placed directly behind the breast tissue, over the pectoral muscle
Submuscular or subpectoral placement:
Breast implants placed under the pectoral muscle, which is located between the breast tissue and chest wall
Sutures:
Stitches used by surgeons to hold skin and tissue together
Transaxillary incision:
An incision made in the underarm area
Ultrasound:
A diagnostic procedure that projects high frequency sound waves into the body and records the echoes as pictures

Visit the Plastic Surgery Glossary for more medical terms.

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