Breast Asymmetry Correction

A slight difference between the breasts is common and, in most cases, normal. When the difference in volume, shape, position or areola appearance is visible and bothersome, it can be corrected surgically. Breast asymmetry correction is not a single operation but a personalised plan, which may combine several techniques.

Depending on the case, the smaller breast may be enlarged, the larger breast reduced, one or both breasts lifted, or the shape and size of the areolas changed. At Detalii Med, in Baia Mare, the procedure is planned and performed by the clinic's plastic surgeons.

The procedure may be suitable for patients who:

• have a visible difference in size or shape between the breasts, noticed after development has finished;
• have tuberous breasts or other developmental variations of the breast gland;
• have been left with asymmetry after pregnancy, breastfeeding or large changes in weight;
• have asymmetry following previous surgery;
• find it difficult to choose a bra or clothing because of the difference.

As a rule, the procedure is recommended once breast development has finished. Any newly appeared change in a breast is first assessed medically.

The correction can significantly reduce differences in volume and shape, can bring the breasts to a similar level and can harmonise the areolas, so that the appearance in clothing and in a bra is balanced.

The procedure cannot create two perfectly identical breasts. A person's breasts are naturally slightly different, and small differences may remain after surgery too. The procedure leaves scars, whose position depends on the technique chosen. Asymmetries caused by the shape of the chest wall or the spine can only be partly compensated.

At the consultation, the plastic surgeon discusses with the patient what bothers her and what result she would like. The breasts are examined, differences in volume and position are measured, and skin quality and chest shape are assessed. The medical history, pregnancies, breastfeeding and future plans are discussed.

The doctor explains the suitable options, for example enlarging a single breast or a combination of enlargement and lift, as well as the associated scars and recovery. An ultrasound scan or mammogram may be recommended before surgery.

The technique is chosen according to the type of asymmetry. The most commonly used methods are:

• enlarging the smaller breast with a breast implant or by transferring the patient's own fat;
• reducing the larger breast, by removing part of the gland, fat and skin;
• lifting the breast (mastopexy) on one or both sides;
• correcting the shape of tuberous breasts and adjusting the areolas.

Sometimes different techniques are used on each breast to achieve as balanced a result as possible. As a guide, the procedure lasts between one and three hours. In certain situations, the correction is carried out in two stages.

The procedure is usually performed under general anaesthesia, following a pre-anaesthetic assessment. Minor corrections, for example a small-volume fat transfer or areola adjustment, can sometimes be done under local anaesthesia, possibly with sedation, depending on the case.

After the procedure, the patient may go home the same day or after one night in hospital. A surgical bra is worn, usually for a few weeks. Discomfort in the first days is controlled with medication, and swelling and bruising gradually subside.

A return to office work usually takes place after one to two weeks. Lifting heavy objects and sport are resumed after about four to six weeks, as advised by the doctor. Stitches are removed or dissolve, and post-operative check-ups allow healing to be monitored.

The risks depend on the techniques used and are discussed at the consultation. They include:

• bleeding, haematoma, infection or fluid collection;
• visible or thickened scars, or delayed healing;
• changes in nipple or skin sensation;
• residual asymmetry or a new difference developing over time;
• with implants: capsular contracture, displacement or the need for replacement over time;
• with fat transfer: partial resorption of the fat, possibly requiring a further session;
• possible difficulties with breastfeeding after a reduction or lift.

A first impression of the result is visible once the swelling has gone down, and the final shape usually takes form within three to six months, when the tissues have settled, while the scars continue to fade for up to a year. The result may be influenced by later pregnancies, changes in weight and ageing.

Breast asymmetry correction is an individualised procedure in which each breast may need a different approach. The aim is a visible and natural balance, not perfect symmetry. The right plan is set at the consultation, after a careful assessment and an open discussion about expectations.