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How to Solve Breast Asymmetry with Cosmetic Surgery

August 8, 2012

Women everywhere struggle with the appearance of their natural breasts. Having two different sized or shaped breasts is a common problem. While some degree of breast asymmetry is normal, many wonder how much of a difference is too much?

Breast asymmetry is defined as size differences between left and the right breasts in form, position, and/or volume. Very few women have naturally symmetric breasts. It is actually more common for women to have one breast that is slight larger or a different shape than the other, but up to 25 percent of adult women have noticeable asymmetry of one cup size or more.

What Causes This?

Most doctors agree that individual breast size is the result of genetics and growth patterns. The hormone estrogen causes adult breast growth within two years of the first menstrual cycle, and the breasts continue to grow over the ensuing 2-4 years. As a result of growth spurts, one breast can grow individually from its partner in size or shape during those years. Also, once the breasts do finish growing they can settle asymmetrically. Estrogen level changes during pregnancy or menopause can also cause breast size or shape to change later in life.

Are My Breasts Finished Growing?

Some women worry about having a corrective surgery prematurely and may want to wait to make sure their breasts will not continue to grow. It is the opinion of most surgeons that breast surgery not be performed before the age of 18. And it is especially important to wait at least two years after your first menstrual cycle because growth patterns are so sporadic during puberty. Many women will notice differences in breast size during the initial growth of puberty, but those can eventually even out.

What Can I Do?

Breast asymmetry can be treated. If the difference is slight (less than one cup size between the breasts), the problem may be solved by inserting extra padding into either the left or right side of a specialty bra. If the issue is more exaggerated, then a cosmetic procedure may be the choice for you. The current landscape of cosmetic surgery has two options to address breast asymmetry: lipoaugmentation (fat grafting) or saline implants.


Lipoaugmentation, also know as autologous fat grafting, is a breast enhancement that uses fat grafts suctioned from fatty areas of the patient’s own body (buttocks, thighs, etc.) to reconstruct the breast. As the current procedural method stands, the survival of the fat cells depends upon injecting only small quantities at a time. It is, therefore, impossible to duplicate the volume possible with an implant. [1]

Saline Implants

According to the FDA, a saline implant is a silicone shell that is filled with a saltwater solution (saline). Unlike a silicone implant which comes pre-filled to the desired size, a saline implant can be filled during surgery. This allows the surgeon to use his or her discretion when filling to produce better results, especially when dealing with the unique cases of asymmetry. A highly specialized surgeon will have the skill set to fill and shape two different sized implants during surgery to create a more symmetrical look. It is essential to go to a board certified plastic surgeon who specializes in different breast enhancement techniques.

Which Choice is Right for Me?

Correcting an abnormality in the breasts requires the artistry of a highly specialized surgeon. If you are looking to increase your breast or breasts by one cup size or more, the saline implant it going to be the better choice, because you cannot achieve more than one cup size of volume using lipoaugmentation. A surgeon is able to fill the saline implants to the desired volume during surgery and make the necessary adjustments to achieve symmetry. The saline implant has also been around longer, so it may be easier to find a surgeon adept in the procedure; however, filling a saline implant during surgery to match a natural breast or filling two implants to unequal sizes to create symmetry takes a very skilled hand. It is important to look through a surgeon’s portfolio to find the most qualified cosmetic surgeon.

Lipoaugmentation, though a newer procedure, does have unique values. While a significantly larger breast size cannot be achieved, fat grafting can allow a surgeon greater control when reshaping the breasts. Fat is malleable, and the right hands can mold it to the desired cosmetic results. It can also be injected in different positions on the breast to create symmetry, be it fuller on the top, left side, or right side. The positioning of the injections can even create the look of more cleavage. But because it is a newer procedure you need to carefully research those surgeons who perform it, as doctors are still facing a learning curve.

A report published in 2009 by the American Society of Plastic Surgeons (ASPS) stated that fat grafting in the breasts is very dependent on the technique and expertise of the surgeon. It is extremely important to research the qualifications of every surgeon and look through portfolios of the work of each.

You can also use a combination of the two techniques to create your desired look. If you want to achieve larger breasts, you can get the saline implants, but still fill around the implant with fat grafts to mold a smoother end shape.

Which Option is Safer?

Any surgery or treatment procedure is going to have inherent risks. Since the saline implant is filled with a sterile liquid, if a leak does occur, the body can absorb the saline without harm. [2] In the case of fat grafting, using your own fat eliminates the risks of rejection.

Breast asymmetry is a common occurrence which is very treatable. Creating symmetrical breasts will, however, required a highly skilled hand. Make sure you research all potential surgeons thoroughly and reference portfolios of their work to get a clear picture of their capabilities.

Explore differences between saline vs silicone implants to learn which option is best for you. Visit our all about breast implants page to find all the information you need including recovery, implant options, risks, and cost of breast implants.

[1] http://www.news-medical.net/news/2008/05/02/38006.aspx
[2] http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics

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