Absolutely equal and symmetrical breasts, a goal for many women, are in fact a rarity. Most women have some slight differences between their breasts (ie their breasts are not mirror images of one another). Other women have significant differences between the two breasts. There may be size, contour, droop or developmental differences. Sometimes one breast simply does not develop at all.
In the adult woman with breast asymmetry, a variety of techniques are available so that breast symmetry may be achieved. For example, if breast enlargement is desired and the breasts are asymmetric in volume, then different sized implants can be used to equalize the final volume in each breast. If breast reduction is desired, then different amounts of tissue can be removed from each breast so that the final result is more symmetric. And in cases of droopy and asymmetric breasts, both breasts can be treated independently to produce uplifted breasts with nipples at the same level. In complicated cases, various techniques may be combined, such as breast augmentation on one side and breast reduction and uplift on the other side. And of course, surgery can be performed on only one breast in an attempt to match it to the other, more normal breast. Each patient is evaluated individually and a final decision for treatment made only after thorough discussion with and input from the patient. In essence, we can design a unique operation specific to your individual needs and wishes.
For teenage girls, the most common breast asymmetry is under or non-development of one breast. At first thought, the obvious treatment would be immediate placement of an implant in the smaller breast. However, this would not keep up with breast development as the years passed – ie you would have to keep replacing the implant with a larger one every few years to keep pace with normal growth of the larger breast. A better alternative is the placement of an implant which can be increased in size whenever necessary simply by the injection of saline (salt water) through the skin and into a valve on the implant designed to accept such an injection. When breast size finally stabilizes, the expanding implant can be removed and replaced with a permanent implant of the proper size.
WHAT TYPE OF ANESTHESIA IS USED?
All operations in the office surgical suite are performed under sedation or “twilight sleep” anesthesia. The anesthesiologist will monitor your vital signs for your safety and administer small, frequent doses of a variety of medications through a vein. The result is a gentle, relaxed sleep while your operation is performed. There is no pain and no awareness and you will awaken quickly and comfortably in the operating room just minutes after the completion of surgery. There is usually no hangover or nausea afterwards.
Operations performed in the hospital are done under general anesthesia, which is administered by an anesthesiologist or nurse anesthetist. This is deeper anesthesia and recovery will be somewhat longer.
HOW IS THE OPERATION PERFORMED?
Photographs are taken prior to surgery. There will be extensive drawings on your breasts to guide the surgeon during the operation. You will be taken to the operating room and prepared for surgery. The surgery will be performed according to the chosen technique. All wounds are closed with multiple layers of dissolving sutures on the inside so that there are no stitches to be removed afterwards – only some tapes on the skin. Drains may be utilized to remove any fluids that might collect inside the breasts. The procedure may take anywhere from 2-4 hours (depending on complexity) to perform. At the end of the operation, you will be placed in a post-operative bra and brought to the recovery room. When you have recovered sufficiently, you will be discharged in the company of another responsible adult.
WHAT CAN I EXPECT AFTER SURGERY?
The effects of the local anesthetic will persist for several hours after surgery – so you will be quite comfortable. Ultimately, these effects will wear off and you will have some soreness, tightness and a pressure sensation on your chest, which will be handled by the pain medication that has been prescribed for you.
There will be some swelling and perhaps some bruising of the breasts and these will disappear within a week or so. Recovery takes about 7-10 days although there is considerable healing during the ensuing months as well. You may drive within 3-4 days and perform only sedentary activities for one week. Strenuous exercise training can be resumed in one month.
Dr Jacobs will schedule several post-operative examinations after your procedure.
WHAT CAN I EXPECT IN THE LONG TERM?
Amazingly, within a week after surgery, your body image in your brain will change and you will accept your new breast size as if you had always been that size!
Your breasts will still be swollen for a while, so please defer shopping for new bras and bathing suits for a few weeks.
You are encouraged to have a post-operative mammogram anytime between six months and a year after your surgery. This will establish a baseline “normal” mammogram so that any future mammograms can be compared to it.
You should return for routine follow-up examination on an annual basis. Any changes in your breasts in-between scheduled appointments should prompt a call to our office.
FREQUENTLY ASKED QUESTIONS
Since breast asymmetry surgery may involve any single or combined techniques of breast augmentation, reduction or uplift, you should read the appropriate FAQ’s under those headings.