Surgery Notes: Unmatched Pair
July 20th, 2009
Women frequently ask about differences in their breast size. This question always comes up when they are considering some type of breast surgery. Differences are normal. Small differences or asymmetry are a part of normal human beauty. I suggest accepting small differences.
Surgery might be considered when the differences are great in both the eye of the patient and the surgeon. Both the surgeon and the patient must agree that the difference is significant. Once this is agreed, surgery may be considered.
Two different procedures may be considered when a patients breasts are two different sizes. The larger breast can be made smaller or the smaller breast can be made larger. Rarely, one breast is made smaller while the other is made larger. As always, these are personal decisions which depend on your preferences for final sizing. As Gina has mentioned in her blog posting last week, she has decided to make her one breast smaller to match the smaller breast size.
Trying on breast implants in a bra helps patients determine the volume representing their asymmetry, but also what should be done. As ever increasing implant sizes are inserted into the side of the smaller breast, a point will be reached where both breasts look the same size. In Gina’s case, she felt she was symmetric in size when she put a 150 ml implant in the bra on her smaller side. This discovery will serve as a guide during surgery. The surgical plan will be removing 150 ml from her larger breast.
Breast tissue removal is the only way to reduce breast size. Generally this is combined with breast lift surgery. In Gina’s case, she does not want the scars that come with a breast lift surgery. She is comfortable with a possible difference in nipple position, if her breasts are made made more symmetrical in size. I will remove the necessary breast volume through a small incision, much like that used for breast enlargement. I anticipate a nice change for Gina when the surgery is completed.
Another possible option is liposuction. Liposuction can be successful when there is relatively more fat than breast tissue and this technique worked for a few years for Gina, until her fibrocystic condition worsened. It is interesting to note that many men with gynecomastia present with fat and slight breast tissue, when liposuction alone is usually successful in reducing their breast size.
Gina will continue to post her patient diary and video clips of her surgery will be added this week, so please check back.
Patient Perspectives: Gina’s Blog
July 17th, 2009
Hello. My name is Gina.
I am a personal trainer and instructor in Minneapolis. I am coming up on my 40th birthday in October. I have been struggling with a fibrocystic breast for the past 7 years. The fibroids are painful when I work out (which is 2-3hrs/day) and they have caused my left breast to become noticeably larger than my right one. As a trainer, symmetry is very important to me, so I set out on a quest to remedy this problem.
I consulted several doctors about a solution and the most common answers were #1-Quit all stimulants, such as caffeine, chocolate, wine, etc. for 6 months and #2-Be happy with my body just the way it is. I am willing to try anything as long as I get my desired end result, so I quit stimulants and gave up my dark chocolate and my white wine for the 6 months. Let’s just say that my husband did not find me pleasurable to around for the first month of this experiment! It was one of the hardest things I’ve had to do, but I thought it would be worth it. Well, it wasn’t. Nothing changed. The fibroids didn’t dissipate, which means I still had one large, painful breast. Needless to say, I am once again enjoying my caffeine!
With the first suggestion checked off of the list, I was left with #2. For the most part, I’m pretty happy with my body and how it looks and also, how it performs on an athletic level. All in all, I’m pretty satisfied. Although, I’m also of the mindset that if you can change something and better yourself physically and mentally, than why not!? Accept what you can’t change and change what you can. So three years ago, I saw Dr. Bashioum for liposuction on my left breast, in hopes that if we took the size down with that procedure, it wouldn’t be so heavy and, therefore, not as painful. Not to mention, the size would maybe match better! It was one of the possible treatments and that approach worked for some time. However, over the past few years, the fibroids have gotten bigger and are pretty much making up almost all of my breast tissue on the affected side. At this point, I am considering additional surgery to correct my asymmetry. I’ll tell you more after my consultation with Dr. Bashioum about my decision whether or not to have a reduction on my left breast.
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