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.
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