No two breasts are identical. Virtually all patients who come in for some kind of breast surgery be it augmentation, lift, reduction, reconstruction or some combination of these, has differences in size, shape and/or position on the chest.
Difference in the size of the breasts is the most common cause of asymmetry. Patients in Columbus, Ohio who are seeking breast augmentation surgery will frequently have a larger implant placed in a smaller breast to improve size symmetry. Those who are going the opposite direction and are undergoing breast reduction surgery will commonly have a larger volume of tissue removed from the larger breast to become more even.
Sagging of the breasts, also referred to as ptosis, is often asymmetric with one breast hanging lower than the other causing a difference in nipple position. Those who are having breast lifts or reductions simply have more skin removed from the breast with more sagging to elevate the entire breast as well as the nipple to a higher position to match the opposite side. Minimal ptosis asymmetry in patients undergoing breast augmentation can sometimes be corrected with differential implant positioning.
Rib cage abnormalities are relatively common in women seeking breast surgery and is often caused by scoliosis resulting in one breast being higher on the chest or off to the side. This is probably the hardest asymmetry to correct as only minor changes can be made. It is important to look for these differences before surgery or they will become more prominent afterwards. Small changes in the crease underneath the breasts can be made to improve symmetry in all types of breast surgery but is particularly important in breast implant surgery.
Areola Size and Shape
A significant difference in the size and shape of the areola is particularly common in patients who are having breast lifts and reductions. As both of these procedures involve removing skin from around the nipple/areola complex, this is generally a fairly easy fix. The size and shape of the areola in these surgeries is marked with a 'cookie cutter' to create a symmetric size and round shape.
Projection of a breast is a distance that it sticks out form the chest wall and can be affected by the size of the breast, the quality of the skin envelope and the shape of the underlying chest wall. Differences in the shape of the ribs, again generally due to scoliosis, can cause significant projection asymmetry and must be accounted for in breast implant surgery or the asymmetry will be exaggerated. In these cases, different implant sizes and often shapes are necessary to achieve satisfactory symmetry.
Although many things can be done to improve breast asymmetry, perfect symmetry will virtually never be achieved despite a surgeon's best effort. Some differences will always remain and should be expected by the patient so that one is not disappointed in the result. In some cases, minor changes can be made as minimal office procedures to improve symmetry int he even that the initial procedure did not make enough corrections.