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BREAST ASYMMETRY SURGERY OPTIONS IN BRISBANE

Scroll down to learn more about the benefits, risks and recovery to consider when thinking about breast asymmetry surgery.

What can be done to treat breast asymmetry?

In general, most women have some breast asymmetry – it is very normal for your nipples to be different shapes, or sit differently on each breast. It is also normal to find that the shape and size of your breasts differs subtly. This is usually only noticeable when you focus specific attention on it.

However in some cases, breast asymmetry can be pronounced, or a symptom of anatomical irregularity or disease. This can be altered through surgery. In such cases, the procedure is considered medically required, and does not constitute cosmetic surgery. Dr Sharp will discuss the best options for you, which could include:

If you notice any irregularities or asymmetry in your breast that you haven’t noted before, it is important to immediately make an appointment with your general practitioner or breast screening service, as this can be a sign of cancer.

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What are the causes of breast asymmetry?

Breast asymmetry is often congenital and can be due to muscular defects such as Poland’s syndrome, chest wall asymmetry or skeletal abnormalities such as pigeon chest or scoliosis. Sometimes, there is an irregularity in breast tissue and positioning, such as in the case of tuberous breasts.

What are the surgical options for breast asymmetry?

Breast asymmetry correction is a reconstructive procedure, with the surgery customised to suit the patient and their underlying condition or anatomy. Surgical approaches can include the use of implants, adjustment of the skeleton or muscle flaps.

Minor breast asymmetry

It is possible to correct moderate breast asymmetry with the use of breast implants. Often, this isn’t the cause of an underlying condition, it is just a slightly more obvious case of the asymmetry every woman experiences.

Anatomical implants come in a wide range of shapes, sizes and profiles, giving surgeons the versatility to choose an implant that will specifically rebalance the smaller breast to have a similar width, height and projection as the larger breast.

It is possible to use an identical height and width for the two sides, but use a different projection or profile to reduce differences in chest wall and / or breast projection.

Dr Sharp will tailor a solution to suit you.

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Breast hypoplasia

Breast hypoplasia is the absence of breast development. There is often a very noticeable difference between the breasts, with one breast often lacking any development.

This is most commonly treated by the placement of an anatomical implant to help create a similar size and projection.

Tuberous breast deformity

Tuberous breast deformity is characterised by:

  • Esize asymmetry
  • Edeficiency of breast volume in the lower part of the breast, creating a tube-like breast shape
  • Elarge areola and nipple sitting low or pointing downwards, giving a ‘drooping’ appearance

Tuberous breast deformity can occur in one or both breasts and occurs in varying ‘degrees’. The severity determines the surgical approach.

The patient often requires augmentation with an implant or expander, alongside a concurrent breast lift and areola reduction. Sometimes this must be done over multiple procedures.

Image, left: before and 12 weeks after two stage breast surgery with Dr Sharp, involving a unilateral breast lift followed by bilateral breast augmentation.

Poland’s syndrome

Poland’s syndrome is characterised by abnormalities to the upper limb and chest, including the muscles of the chest wall – and breast, nipple and areola underdevelopment, specifically

  • Echest wall bony structures absent
  • Efinger and hand abnormalities
  • Eabsence of chest wall muscles (e.g. latissimus dorsi or pectoralis major)
  • Eabsence of nipple, or;
  • Ehigh nipple position
Depending on the severity of underdeveloped, different techniques are employed by Dr Sharp to correct the chest wall’s contours and shape.

Using advanced microsurgical techniques, a latissimus dorsi flap followed by and breast implants are the most common forms of reconstruction. Techniques also include :

  • EBreast mound reconstruction with a tissue expander - which is inflated over time to help the skin stretch and accommodate the implantation of a permanent breast prosthesis down the track
  • EReconstruction of the underlying deformed chest wall
  • EFlap reconstruction using a latissimus dorsi or a free flap reconstruction, known as a ‘TRAM’ flap

Rib cage deformity

There are two kinds of common chest wall deformities:

  • EPectus Carinatum: also know as ‘pidgeon chest’, whereby the breast bone protrudes between the breasts
  • EPectus Excavatum: when the breast bone and ribs sink deep towards the back, giving a cavernous appearance
These deformities can be one one side (unilateral) or both sides (bilateral).

In mild cases, breast augmentation is usually sufficient to correct the asymmetry. More severe abnormalities require referral to a thoracic surgeon. Chest wall shape correction may be required before a pleasing aesthetic breast result can be achieved using implants.

Risks and recovery

During your surgical consultation process you will meet with Dr Sharp twice to consider the risks and recovery involved with your surgery. You will receive a copy of these twice during this process.

The recovery from asymmetry surgery improvement will vary depending on the surgical plan required, as there is not a ‘one size fits all’ approach.

If breast augmentation using implants is required, details can be found here. If a mastopexy (lift) is needed, the pertinent information can be found here.

Dr David Sharp plastic sugeon

Research shows that in Australia, approximately 20,000 women undergo breast device surgery each year. Cosmetic surgery (and elective surgery in general) in Australia has low mortality and morbidity rates when performed by appropriately trained surgeons, on healthy surgical candidates, in an accredited facilities.

But like any surgery, you must weigh up whether the benefits of breast augmentation outweigh the risks for you. While breast augmentation surgery is one of the most commonly performed cosmetic procedures in Australia, it is an operation, and as such it carries risks. Your pre-operative consultations with Dr Sharp will enable him to discuss potential complications with you, and help you determine whether the surgery is right for you.

What is a complication?

Surgery aims to create improvements. Where a patient achieves an improvement, but does not perceive it to be enough of an improvement, this is not considered a surgical ‘complication’. Read more about the classification of complications here.

A surgical complication is an unexpected deviation from the normal surgical course.  For example, not liking your postoperative breast size is not a complication, but a blood clot or nipple skin necrosis (death) is a complication.

Possible complications of surgery in general include:

  • Acute medical event such as stoke, heart attack, pneumonia
  • The need for revision or further surgery 
  • Pain which does not respond to pain relief 
  • Nerve damage, causing altered sensation or loss of sensation – temporary or permanent
  • Haematoma (collection of blood), oedema (collection of fluid) and abscess 
  • Deep vein thrombosis (DVT) or pulmonary embolisms (PE)
  • Damage or or loss of loose teeth during placement of anaesthetic apparatus
  • Sore throat, swelling or discomfort following placement of breathing tubes during anaesthetic 
  • Breathing difficulties following anaesthetic
  • Allergic reaction to medication 
  • Allergic reaction to sutures, dressings, tapes or intraoperative solutions
  • Heavy bleeding from the wound, which may require further surgery
  • Poor or slow skin healing, wound infection, breakdown or necrosis (skin death)
  • Wound dehiscence (incision separation)
  • Adverse scarring
  • Psychological impact of surgery, recovery or altered appearance
  • Death

Specific breast asymmetry surgery risks include:

  • Changes in nipple or breast sensation
  • Wrong or faulty position of the implant
  • Implant leakage or rupture
  • The formation of tight scar tissue around the implant (capsular contracture)
  • Wrinkling of the skin over the implant or rippling – this is common in women with low breast tissue
  • Pain, which may persist
  • Possibility of revisional surgery
  • Areola enlargement
  • Migration or altered position of implant
  • Contour deformities
  • Aesthetic concerns, such as asymmetry
  • BIA-ALCL or breast implant illness; two rare conditions that are explored in detail, in the dedicated linked articles.

Complications are rare, but they do occur despite the patient and surgeon’s best efforts to avoid them – so it is important to consider how they may impact you physically, emotionally and financially if they do arise.

Dr Sharp and his team manage known risks with the upmost care to further reduce the likelihood of them occurring. In the event they do occur, most can be treated with prompt intervention.

Everyone’s body responds differently to surgery. In some cases, post-operative revision surgery might be required.

How do we reduce the chance of complications occurring?

  • We select healthy candidates for surgery – that means physically and mentally, they are in the best possible condition to undergo their procedure
  • Dr Sharp is a specialist plastic surgeon, which means he has the appropriate training and qualifications to perform breast augmentation surgery
  • We operate in accredited facilities with a specialist anaesthetist present

Some factors, such as weight, lifestyle or health problems can increase the chance of a complication occurring. Dr Sharp will take time to learn about your potential risk factors during your pre-operative consultations, and will determine if they are relevant to your surgery.

Breast surgery recovery

 

Immediately after your surgery, you will be taken into a recovery area to be closely monitored. Your support bra will be placed on during the surgery, so you will be wearing this when you wake up, helping to minimise swelling and support the breasts as they heal.

Most patients have this procedure as a day case, meaning they go home a few hours after surgery.

After a post-surgical breast augmentation recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks, or even months.

During this time, you will have support of our post operative care team, who is available 7 days a week, should you have any urgent concerns.

You will return to the clinic for your tapes to be changed at 1 week post op and for further instructions regarding taping and massaging your scars with silicone gel, which is an important part of your recovery and scar optimisation.

Your support bra is worn for at least 12 weeks, 24/7. After this, you can start wearing soft cup, supportive bras (and no underwire for at least 12 weeks thereafter). We recommend wearing a supportive bra moving forward, as you will find over time your breasts will sag and implants may drop, without support.

Dr Sharp and your post operative care nurse will give you specific instructions on ongoing wound care, to achieve optimal healing and results. These instructions may include:

  • How to care for your surgical site/s following surgery
  • Medications to apply or take orally to aid healing and reduce the risk of infection
  • Specific concerns to look for at the surgical site/s or in your general health
  • When to follow-up with Dr Sharp in the rooms

Following breast augmentation surgery you will be unable to drive for at leat 1 week. You also won’t be able to exert yourself or lift anything heavier than 2kg for at least 6 weeks. After this, you will gradually return to normal activities, slowly reintroducing your body to them over the subsequent 6 weeks. This is a slow process and can pose some challenges for patients who are very active! It can also have repercussion for work and family activities during the recovery period.

After the initial 7 days post surgery, most patients experience low levels of discomfort.

During the recovery process, a combination of swelling, disrupted chest muscles and nerves cut (or compressed) by surgery can cause tingling, stinging or sharp pains in the breast. This is a normal part of the recovery process.

You will be prescribed pain relief for any discomfort, but if you have a low pain threshold or post operative trauma from previous surgeries, it is important to consider the potential impact of post operative pain on your mental health. Making arrangements preoperatively to have support in place (via psychologist, GP, family or friends) is recommended if you think this may apply to you.

Post operative concerns such as pain, sudden shape change or increased swelling that appears months or years after surgery requires further investigation, guided by your surgeon; please contact the clinic promptly if this arises.

At your consultation, Dr Sharp will answer specific questions about what you can expect during your individual recovery period:

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? If so, when will they be removed?
  • Are stitches removed? When will they be removed?
  • When can I resume normal activity and exercise?
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