The Management of Breast Asymmetry

Breast asymmetry is an extremely common problem amongst women. In most cases, this is relatively minor and women aren’t bothered by it. Occasionally, it can be severe and treatment is necessary.

A multitude of options can be used to treat this problem. These may include breast reduction, breast lift, breast augmentation, or various combinations of these procedures.

It’s important to realize every patient is unique. They have specific aesthetic goals and unique anatomic findings. The specific treatment for any individual patient will depend entirely upon these issues.

Liposuction for Men

Liposuction is one of the most commonly performed cosmetic surgical procedures in men. The flanks, abdomen, chest, and neck appear to be the most commonly treated areas. This procedure is
associated with high satisfaction rates when patients are near their ideal body weight.

Liposuction in men has limitations because the fat tends to be more fibrous. In addition, a large amount of the abdominal fat is located within the abdominal cavity where it can’t be reached by a liposuction canula. These characteristics can limit the amount of fat that can be removed with this procedure. Men generally have thicker skin than women and as a result, skin sag is less likely to occur in this group.In some cases, ultrasonic liposuction has been found to be helpful when performing liposuction on men. In theory, this procedure results in skin tightening as well.

Facelift Surgery for Rejuvenation of the Neck

It’s not unusual to see women who have significant changes in their neck area as a result of facial aging. In many cases, this may be the primary manifestation of aging, with the face itself being relatively unaffected. These changes may include loss of definition of the jaw line, loss of the sharp angle between the neck and jaw, laxity of the underlying neck muscles with the formation of bands called turkey gobblers, fat accumulation, and of course excess skin. To obtain an excellent result, all of these issues need to be addressed. With this in mind it’s important to remember that all patients have unique facial anatomy and specific aesthetic goals. Therefore, treatment plans may vary from patient to patient depending upon their underlying anatomic deformity.

The procedure that is most likely to accomplish these goals is a facelift. This procedure corrects the abnormalities of the underlying muscles which ultimately defines the jaw line, removes the neck bands, and improves the angle between the jaw and neck. It also addresses fat accumulation and excess skin to further accentuate these improvements.

Capsular Contracture Following Breast Augmentation

It’s normal for your body to react to a foreign material such as a breast implant by forming a scar. This scar surrounds the breast implant and is known as a capsule. Capsule formation occurs in every patient to some degree following breast augmentation. In most cases, this represents a normal response to a foreign material being placed inside your body.

Without capsule formation, implants don’t stay in one place. When this happens, implants migrate and secondary pocket revision may be necessary. In some cases, capsule formation occurs in an aggressive form, which results in a capsular contracture. In severe cases of capsular contracture, the breast implants become hard, distorted, displaced, and painful. The majority of capsular contractures develop within six months of surgery, but they can develop at any time.

There’s no laboratory or radiology test that makes the diagnosis. The diagnosis is entirely based on physical examination.

Teen Breast Reduction


When younger patients have significant breast enlargement with associated symptoms, we don’t feel that they should be denied the benefits of this procedure because of an arbitrary age cutoff. Before proceeding, there are several unique considerations in this group that must be considered.

One of these is the issue of breast growth. We would prefer stabilization of breast growth for at least six months prior to proceeding with surgery. Another issue is the age of consent. Because of this, parents should be involved in every step of the decision- making process.

Choosing a Plastic Surgeon

It’s important for patients to be comfortable with their choice of plastic surgeon before proceeding with cosmetic surgery. When choosing a surgeon, several issues should be considered. These include the surgeon’s training, certification, and experience.

Completion of a plastic surgery residency is an essential requirement when picking a surgeon. Although it seems obvious that cosmetic surgery is a procedure that should be performed by someone trained in plastic surgery, this is not always the case. There are many physicians who perform cosmetic surgery who haven’t completed plastic surgery training. They frequently refer to themselves as cosmetic surgeons and have trained in a variety of other areas.

Board-certification is also extremely important. This means that your surgeon has undergone testing and peer review. He or she has satisfied certain criteria that are associated with surgical excellence.

One of the most important factors is your surgeon’s level of experience. Surgeons who have extensive experience with aesthetic surgery tend to have higher success rates.

Breast Augmentation Options

Several questions need to be answered before proceeding with breast augmentation surgery.  These pertain to the following issues: 1) Implant size, 2) Implant type, 3) Incision location, 4) Under or the over muscle, and 5) With or without a breast lift.

Depending upon the answers to these questions, a large variety of treatment options potentially exist. Each patient should be considered individually since no two patients are the same. Patients may have unique anatomic findings and specific aesthetic goals that impact their treatment plan.

In general terms, data shows that the majority of implants are placed under the muscle through an inframammary approach.  There is a greater tendency to use silicone gel implants than saline implants, but saline implants are still frequently used.