The Surgeon Minute

Sisters, Not Twins: Enhancing Asymmetric Breasts

Sisters, Not Twins: Enhancing Asymmetric Breasts

Whether you have noticed it before or not, breasts are not perfectly symmetric. It is completely natural to have slight differences between your left and right breast! For some women, however, these differences are more pronounced and noticeable. Aging, weight fluctuations, pregnancy and breastfeeding can all contribute to increased differences in breast size and shape over time.

Women considering breast enhancement surgery to improve their size or shape should  be fully aware of the differences in breast symmetry prior to surgery so that they can achieve the best result possible.

The most important thing you have to realize is that breasts are not twins. They’re sisters,” explains board certified plastic surgeon Dr. Charles Messa. “I point out these asymmetries so that patients are more aware of them. With specific surgical techniques, I can help patients achieve a more symmetric appearance.”

Beginning with the Consultation

When a patient sees Dr. Messa regarding breast enhancement, his priority is to understand the patient’s goals. Do they desire more fullness, improved shape, a lift? Looking through pictures of breasts the patient finds attractive is helpful in understanding the look they are after. However, Messa is quick to explain to his patients that whether or not they will be able to achieve those results depends largely on their unique anatomy.“Many times women say, ‘Oh I like my friend’s breasts,’ or, ‘I saw these breasts online.’ That’s great, to understand how they perceive an attractive breast, but that doesn’t necessarily mean they can achieve those results,” Messa shares.


Once he has a good understanding of the patients breast enhancement goals, Messa will analyze their anatomy and determine which surgical techniques will best help them achieve the aesthetic they desire. “It really depends on the degree of asymmetry, the appearance goals of the patient and what their anatomy dictates in terms of breast tissue volume, breast tissue laxity, and skin excess,” says Messa.

Augmentation to Correct Slight Asymmetry

A study of over 600 women women found that the left breast is more commonly larger than the right breast. Women desiring increased volume who begin with a slight difference in size can often achieve more symmetric breasts by using a slightly smaller implant on the breast that is larger to begin with.

Correcting More Severe Asymmetry

Patients with severe asymmetric breasts have many surgical options to choose from. A higher degree of symmetry can be achieved through a combination procedure.

Dr. Messa may recommend augmentation for the smaller breast and a lift or reduction for the larger breast. In some cases, both breasts may require a lift, with one breast being lifted more than the other. Which procedures are selected depends on three main factors: the patient’s aesthetic goals, their degree of asymmetry and their breast anatomy.

Correcting asymmetric breasts - Messa.

Important to take into account:

  • Degree of asymmetry
  • Patient goals
  • Breast anatomy: volume, tissue laxity & excess skin

“They may decide that they just want to reduce one breast and leave the other breast completely alone,” says Messa.  “It comes down to #1: What are the patients individual appearance goals? That’s most important. Then, with the tools we have available, we can do either a breast augmentation to one or both breasts, a breast lift (or mastopexy) to one or both, and/or a breast reduction, where we’re removing breast tissue.”

Surgical Options to Achieve Symmetry:

  • >Augmentation to one or both breasts
  • Reduction to one or both breasts
  • Breast lift to one or both breasts
  • Combination augmentation/lift to one or both breasts

Breast Augmentation Consultation is Always Key

The time to voice desires, opinions, and thoughts is during a deep consultation with an experienced breast surgeon the patient feels they can trust. Once all of the variables are ironed out – including whether or not to correct asymmetric breasts – then all the surgeon has to do is step into the OR and execute the plan. When patients do their homework, discuss the procedure in depth with the surgeon, and properly consider their own desires, breast augmentation results can be incredibly rewarding.

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