Breast Anomalies and Asymmetry Cases

Asymmetry issues in the breast are not uncommon. They are, however often underestimated and undertreated. I am often called upon to correct persistent or never treated asymmetries.

This patient presented with what appears at first to be a minor asymmetry but in fact would have been magnified significantly if it were not corrected with her surgery! The nipple-areola complex is at completely different positions pre-op. The breast folds are completely different shapes with the left breast actually a constricted malformation.

So, I release the constriction, did a per-areola mastopexy on the left and bilateral silicone gel augmentation. A work of art and a beautiful full B outcome.

Case Study Categories: Breast Anomalies and Asymmetry.

This patient presented with an asymmetry of volume and asymmetry of the skin envelope. The sag has been taken up by an internal restructuring to allow for preferential fill centrally. A fine C/D cup outcome with silicone gel implants.

Case Study Categories: Breast Anomalies and Asymmetry.

This patient presented with a subtle but challenging breast issue. Aside from hypoplasia (small AA cup size) she had a large, pouting out full areola which was very close to the inframammary fold.

I had to release the bands around the areola, lift the nipple-areola by periareolar mastopexy, release the original breast fold, recreate a new fold and stretch nipple to fold distance and augment the breast with silicone implants – all in one procedure.

An outstanding small C cup outcome.

Case Study Categories: Breast Anomalies and Asymmetry.

This woman presented with a severe form of Poland’s Syndrome, a developmental anomaly that left her with a partially missing rib cage, partially missing chest muscles, absent breast, and mal-positioned anomalous tiny nipple.

I reconstructed her in stages using a latissimus muscle only flap and expander initially, followed by a recreation of breast fold, and implant placement on the right and opposite breast symmetry procedure augmentation. Finally nipple reconstruction was done.

A remarkable outstanding result in one of the most challenging cases in plastic surgery.

Case Study Categories: Breast Anomalies and Asymmetry.

This patient presented with bilateral tuberous breasts, ptosis (sag) and constricted breast anomaly. This is one of the most challenging (if not the most challenging combination of findings that plastic surgeons must face regarding aesthetic breast surgery). The plan here included reduction (elimination) of sagging elements, elevation and resizing the nipple and areola, and implant augmentation to yield a final C cup outcome. (Lift alone would have only given a small B cup breast.) An outstanding result.

Case Study Categories: Breast Anomalies and Asymmetry.

This woman presented with dramatically asymmetric breasts. The right breast was an A cup and the left breast was a very sagged fuller B cup (top row of 3 in 2 sets of photos). This presents a series of complex challenges. How to create shape, symmetry, size match, and nipple position equality? How can all this be done while maintaining vital blood supply to tissues? Many surgeons would opt to do it as a 2 stage procedure because of the complexities of spatial creation and surgical execution. That would require 2 recoveries in a 6-month interval. The outcome may depend on scar formation from the first procedure.

I routinely combine this into one surgery with implant placement under the muscle canopy, removal of left breast excess tissue,  and llifting of the left with significant reshaping.

Look carefully at the armpit region. Among many other things, I eliminated the excess fatty fullness which created an unsightly bulge, by liposuction and release.

She is shown (bottom 3 views in each set) 4 months later with a nicely healed, beautifully aesthetic C cup outcome. A great triumph!

Case Study Categories: Breast Anomalies and Asymmetry.

This shows a case of severely constricted breast anomaly combined with tuberous herniation of nipple and areola. These problems are among the most challenging conditions for plastic surgeons to address in aesthetic breast surgery. In this condition the volume is not only minimal, but the footprint of the breast is too small and tight bands around the nipple cause it to herniate relative to the surrounding skin.

The outcome is truly outstanding. It vividly shows how my approach of creating an internal bra space with the variable release of tissue aids in improving the aesthetics of her breast.

Case Study Categories: Breast Anomalies and Asymmetry.

A very difficult problem to correct is severe hypoplasia with tuberous herniations through the nipple complex.

Successful treatment included approaches through the areola complex and from under the breast in this case but scars are barely discernible.

Case Study Categories: Breast Anomalies and Asymmetry.

This patient presented with asymmetric breast sag and volume asymmetry as well. The nipple and areola were also uneven. Surgery to correct these problems included; a lift, a small reduction of the most sagging tissue, reshaping of both breasts, and implants to create a more balanced and youthful appearance. An outstanding outcome in a difficult case.

Case Study Categories: Breast Anomalies and Asymmetry.

This case shows how mild tubular breast anomaly can be successfully treated with augmentation. In this case, under the muscle with saline implants and less than one-inch crease incision. An excellent result.

Case Study Categories: Breast Anomalies and Asymmetry.