For optimal results in breast augmentation the breast tissue needs to be centered under the nipple which should lie about 20cm from the notch between the collar bones, the areola should be about 4cm in diameter & the implant should be centered under both the nipple and breast tissue. Uneven breasts can be due to differences in breast size alone or in some combination with breast shape, nipple position, breast crease position and underlying rib cage shape. The required surgery can only be planned when the causes for asymmetry are discerned by a face to face physical examination. In severe cases imaging studies may be required before any surgery is planned. The surgeon has to pull from his/her entire bag of surgery to treat these cases including fat grafting, using different sized breast implants, acellular dermal matrix slings, mastopexy, inframammary fold creation etc.. In order to fine tune the size saline implants are usually better than silicone because the difference can be as little as 5 or 10cc.
Minor asymmetries can be corrected in one surgery. For moderate or severe asymmetries a staged approach with 2 or 3 operations a few months apart yields the best results.
Depending on your health insurance policy this surgery may be covered by health insurance. Some policies require a 2 bra cup size difference in order to cover the surgery. For plans issued in California the state law requires coverage if a layperson looking at the condition would consider it abnormal looking.
23 years old, 5’3″ tall, 110 lb., 32B bra size
Smooth saline implants (400cc on the right and 375cc on the left) were placed under the muscle. In this case both nipples had to be moved closer to the midline during surgery using differently positioned crescent mastopexies. Adjustments also had to be made for difference in the positioning of the right and left ribs that make an exactly symmetric result unachievable.
Video: Uneven Breast Surgery
This patient had fat transfer breast augmentation in addition to breast implants for a better result than either option alone.
Read Dr. Stone’s blog about breast surgeryTypes of Breast Lift – Mastopexy
Fat Injections to Reconstruct Breasts or Increase Breast Size
Massive Weight Loss and Breast Reduction Surgery
Breast Implants and Body Building
A Natural Look with Breast Implants
Uneven breast surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.
The only alternatives to breast implant surgery are padded bras or free fat grafting. The problems with only injecting fat to increase breast size are multiple fat graft sessions would be required to reach the equivalent size of an implant and fat alone lacks structural integrity. Therefore to get the breast to protrude sufficiently you may need a base diameter that would be too large for your chest.
As with any type of surgery there is the risk of infection or bleeding. Additionally breast implants may interfere with future mammograms, some patient’s body’s just do not tolerate implants, your body can form scar tissue around the implants that contracts down forming hard balls, asymmetries present before surgery can be magnified (especially if your surgeon does not account for them in planning surgery), unsightly skin scars can form at the implant insertion site, seroma fluid or blood can collect around an implant necessitating additional surgery, implants can rupture at any time necessitating further surgery, if non-cohesive silicone gel leaks out of an implant it can migrate to adjacent body areas, if the overlying breast tissue is thin the edges of the implant or its surface rippling may become visible, implants placed under the muscle can be deformed when the muscle is active or shift out of position due to muscle action, if there are any problems with the overlying skin or infection the implant can extrude and if the implants are removed you could be smaller than your original breast size and have a non-cosmetic appearance of your breast(s). Some risks are common with specific approaches such as implant malposition with implant insertion through the belly button.
These risks are minimized by choosing the right surgeon and implant, not getting too large a breast implant, complying with activity restrictions in the immediate postoperative period and taking prophylactic antibiotics when undergoing dental work or gastrointestinal procedures. Most surgeons now use cohesive gel when the use silicone implants so the risk of rupture and migration is not an issue but these implants require larger skin incisions and therefore more skin scarring.
Unlike other types of plastic surgery all breast implant patients are signing up for future surgery because the implants do not last a lifetime and the effects of the surgery do not last a lifetime. Despite all of this breast implant augmentation is within the top 2 or 3 cosmetic procedures performed by plastic surgeons in the United States each year.
The benefits are not being self conscious shopping for clothes, when in a bathing suit at the beach or when being intimate. Being pleased with your new appearance can be a major incentive to changing your lifestyle, diet and exercise regularity in order to maintain your new look.
In order to have a well perceived result patients need to have the proper expectations going into surgery and the appropriate patient specific surgery needs to be employed. The patients shown on this webpage each had specific problems and needed individualized treatment. This is not only a make an incision insert an implant procedure. That may work for some patients but it will not work for all patients.
Automobile driving can be resumed after 1 week, sex after 2 weeks & athletics after 4 weeks. The most important part of recovery is exercise and activity restrictions for 3 to 4 weeks after surgery after which patients gradually return to their pre-surgery exercise routines. Being to active too early after surgery can easily lead to seromas, infections or implant malpositions that adversely affect the end result. Most of the bruising & swelling resolves in 2 to 3 weeks. A bra should be worn 24 hours a day for 4 to 6 weeks until the capsule around the implant is fully formed. If the implant is riding high initially a velcro strap is placed around the upper chest for a few weeks to reposition the implant(s).
If implants were placed via an armpit incision do not use roll on or spray antiperspirant or antideodorant in the armpit area for 2 weeks and do not shave the armpit area for the first 10 days after surgery.
Dr. Aaron Stone
Call today for a consultation!120 South Spalding Dr, Suite 330
Beverly Hills, Los Angeles,CA 90212