Breast Asymmetry Surgery – the balancing act

Whilst it is true that no woman ever has perfectly symmetrical breasts, different degrees of asymmetry may cause enough concern for a woman to seek further treatment. These asymmetries may be in terms of volume, with a larger breast on one side and a smaller breast on the other, a difference in droop to the breasts, differences in nipple position or all of the above. In addition we all have various other asymmetries and differences between left and right halves of our bodies so an uneven chest wall with even breasts on top may result in an appearance of uneven breasts and unequal breasts where as there is actually an underlying chest wall (rib cage) issue fundamentally.

So what can be done to improve breast asymmetry?

The ideal situation from a plastic surgeon’s perspective is one in which the larger breast can be reduced to match the smaller breast. This is because the ability to achieve symmetry in terms of volume but also in terms of behaviour and character of the breast is far more predictable. However, of course, the patient may desire a final breast size that is larger than her smaller breast in which case at a later stage, a breast augmentation may be performed. This might also be possible at the same time.

Another situation may be encountered in which both breasts are somewhat empty or under developed and therefore a breast implant would be needed on both sides. In the past there was a vogue to use differential breast augmentations i.e. a larger breast implant on the smaller breast, however nowadays wherever possible, we prefer to lift or reduce the larger breast prior to using equal sized breast implants on both sides. This is so that the final breasts both have similar proportion of breast tissue and implant to ensure they behave as equally as possible. What we mean by breast behaviour may mean for example what happens to the breasts when you lie down, do they fall to the side or does one stay standing up? It also may mean how they behave on leaning forward or during exercise.

Nipple asymmetry and position of the nipple on the breast can also be an important factor to treat. Nipple position can be adjusted on a breast and this is normally in the form of lifting to a higher position, however, occasionally, nipples can be moved towards a more midline position or away from the midline if necessary.

At the end of the day, there are many potential options. The best option needs to be determined after careful clinical examination. If you have concerns about breast asymmetry or would like a professional opinion, please get in touch on 01892 619 635 or

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