Breast reduction to fix asymmetry is a highly complex procedure. Contrary to popular belief, the lopsidedness is not only caused by the size disparity between the two sides; several factors also come into play like the nipple size and position, difference in the projection of each breast—even the shape of the chest wall may also contribute to the condition.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says every woman has uneven breasts; however, it only becomes problematic when the lopsided appearance prevents someone from wearing a swimwear without feeling too conscious, or tries to hide it by changing the way she dresses (e.g., using pad only on one side).
Dr. Smiley says that no patient should expect perfect symmetry after breast reduction or any other forms of breast enhancement surgery, although a good surgeon will make every effort to make each breast quite similar to each other.
The celebrity plastic surgeon says that breast reduction to fix asymmetry may involve just the larger breast—reshaping and reducing its size to make it more symmetric with the other side.
However, one caveat of leaving the other breast “untouched” is that it will not behave the same way as the surgically enhanced side, warns Dr. Smiley.
To achieve a good level of symmetry that can persist long term (both sides will “mature” and “behave” quite similar), Dr. Smiley says that breast reduction or any form of breast surgery should ideally involve both sides.
With breast reduction, whether or not there is a notable size difference between the two breasts, Dr. Smiley says the vast majority of patients will also require some type of mastopexy, or breast lift in layman’s term.
Breast lift and breast reduction share the same incision sites and thus additional scars are not an issue.
Breast lift not just repositions the downward pointing nipple; it also raises and reshapes the breast tissue with the use of internal sutures, explains Dr. Smiley.
To further improve symmetry, Dr. Smiley says he uses a device that resembles a cookie cutter to delineate the new smaller areola. He also ensures that the scar goes precisely at the dark-light skin junction so it blends well into the background.