Breast asymmetry is the difference in the size and shape of the left and right breast. In most cases, breast asymmetry is an individual feature of a woman and represents an exclusively aesthetic disadvantage. Breast asymmetry can manifest itself in unilateral micro- or macromastia, tubular structure of the mammary glands, mastoptosis, etc. Depending on the type and degree of breast asymmetry, endoprosthetics of a smaller breast, reduction mammoplasty of a larger breast, mastopexy or breast lift with simultaneous prosthetics with silicone implants can be performed.
Breast asymmetry is a disproportion of the mammary glands, consisting in their unequal shape and/ or size. Natural breast asymmetry is characteristic of more than 80% of women. Usually it is expressed in a slight difference in the volume of the mammary glands, not exceeding one size. In these cases, breast asymmetry is not pronounced, does not cause inconvenience to a woman and is practically invisible to others. This feature is not a pathology and does not need correction. At the same time, the difference in the size, position and shape of the mammary glands and nipples can be so obvious that it causes a woman physical and psychological discomfort, forcing her to seek help from a plastic surgeon.
Causes of breast asymmetry
Breast asymmetry can be genetically determined or acquired, occurring throughout life due to hormonal changes, injuries or diseases of the mammary glands. In almost every person, the right and left halves of the body are more or less asymmetrical. These differences may relate to facial features, the position of the ears, the shape and size of the mammary glands, the size of the legs, etc. Such a natural disproportion is inherent in us genetically and is not considered a pathology. In this case, breast asymmetry usually manifests itself during puberty, but by the end of puberty it may become less pronounced or disappear on its own. Sometimes congenital breast asymmetry is associated with a malformation – congenital hypoplasia of glandular tissue.
The prerequisites for acquired breast asymmetry can be mechanical injuries of the mammary glands, burns, scars. In women who have previously undergone breast augmentation surgery, asymmetry may be associated with the displacement of the implant or the development of capsular contracture. Breast asymmetry can develop during breastfeeding in the case when there is unequal emptying of the mammary glands due to uneven pumping, preferential application of the child to one breast, cracked nipples, lactostasis, etc. After the end of lactation, the difference between the mammary glands gradually decreases, however, as a rule, the asymmetry still remains. Hormonal changes in the size and shape of the mammary glands can also occur during menopause. Finally, the most dangerous causes can be diseases of the mammary glands – mastopathy, benign and malignant neoplasms. Separate studies on mammology indicate that breast asymmetry itself is a factor of increased risk of breast cancer.
Types of breast asymmetry and their correction
Taking into account the difference in the size of the mammary glands in plastic surgery, there are three degrees of breast asymmetry: light (the differences between the mammary glands are insignificant and do not require surgery), medium (one mammary gland is 1/3 larger than the other), heavy (one mammary gland is 1/2 larger than the other). In clinical practice, there may be various variants (in volume, shape, degree of ptosis, position of the nipple and areola) that require different tactics.
Breast hypoplasia is manifested by a delay in the development of one breast with a normally developed other. In this case, to correct the asymmetry of the breast, the patient may need an endoprosthesis of a smaller breast with a silicone implant. The reverse situation is observed with breast hypertrophy, when there is an excessive enlargement of one breast and the normal development of the second. Tactics for this kind will include reduction mammoplasty – reduction of a larger breast. It is possible that hypoplasia of one breast and hypertrophy of the other is noted – in such cases, an increase in the smaller breast and reduction of the hypertrophied one is carried out.
The asymmetry of the breast shape can be manifested by the following variants: the tubular structure of both mammary glands, equal in volume; the tubular structure and a decrease in one breast or the tubular structure and an increase in one breast. The tubular mammary glands are spoken of if the breast has not the shape of a hemisphere, but an elongated tube (“proboscis”), topped with a stretched areola. With tubular glands, their shape and size are changed without the use or with the use of implants.
The asymmetry of the position is expressed in the following possible variants: lowering of both mammary glands to a different level; lowering of one breast. With mastoptosis, a breast lift (mastopexy) is performed by periareolar, T-shaped, vertical or L-shaped access. Sometimes endoprosthesis or reduction of the mammary glands is performed simultaneously with mastopexy.
In addition to the disproportion of the size, shape and position of the mammary glands, breast asymmetry may be manifested by the unequal diameter of the areoles or the shape of the nipples, requiring correction of the nipple-areolar complex.
Pronounced and noticeable breast asymmetry gives rise to various psychological disorders in a woman, creates difficulties with choosing beautiful and elegant underwear, causes discomfort when visiting the beach, sauna, sauna, swimming pool. Often, breast asymmetry becomes an obstacle to entering into intimate relationships, since a woman has an insurmountable fear of showing her naked body.
Preparation for surgical correction
In most situations, methods of non-surgical correction of breast asymmetry do not lead to a noticeable and long-term result. Nevertheless, if the differences in the size and shape of the breast are small, alternative surgical options should be considered first: wearing corrective underwear, massage to correct the bust, mesotherapy to strengthen the breast, hardware breast lifting (myostimulation, etc.), breast lipofilling.
In order to determine the indications and contraindications for surgical correction of breast asymmetry, it is necessary to undergo a full-fledged medical examination, including a general blood and urine analysis, biochemical blood analysis, coagulogram, determination of blood group and Rh factor, blood testing for RW, HIV, HCV, HCV. Of the methods of instrumental diagnostics, an electrocardiogram and fluorography are required, as well as obtaining the conclusion of a therapist or cardiologist. In addition, the preoperative examination plan includes ultrasound of the mammary glands or mammography with subsequent consultation of a mammologist.
Directly at the consultation of a plastic surgeon, the question of the expediency of carrying out a particular type of mammoplasty is decided. During the examination and conversation, the expected result is discussed, anthropometric measurements are made, the implant is selected and its location is determined, the place and shape of the future incision is determined. In order to visualize how the bust will look after the operation, a computer simulation of the breast is performed. Correction of breast asymmetry is not performed surgically in patients with diabetes mellitus, high arterial hypertension, decompensated cardiovascular diseases, coagulopathies, oncopathology, incomplete lactation.
It should be remembered that aesthetic correction carries a lot of risks, including such specific complications as implant displacement, development of capsular contracture, scarring, marginal skin necrosis, skin pigmentation, etc. With hypercorrection or insufficient correction, breast asymmetry can not only persist, but also increase. The naturalness and naturalness of the new bust will depend not only on the skill of the surgeon, but also on the behavior of the woman herself: lifestyle, compliance with the doctor’s prescriptions, the condition of her own breast tissues.