Recently, New You Magazine covered the age old question of asymmetrical breasts. Dr. Todd K Malan, M.D., of Scottsdale, Az. was called upon to discuss a new option for women looking to correct this problem. Fat Transfer procedures allow a patient to harvest fat from a problem area and transfer to their breast. Dr. Malan meticulously injects the fat so both breasts are even in size and shape.
Breast In Balance / by Lisette Hilton
Nearly all women have some degree of asymmetry between their breasts. But for those whose breasts are markedly different, whether in size or shape, breast asymmetry can turn into a cosmetic nightmare.
“It’s normal to have a 1 percent to 2 percent difference between breasts,” says Todd K. Malan, MD, a cosmetic surgeon in Scottsdale, Ariz.
Dr. Malan explains that women tend to seek out cosmetic surgery solutions when the size difference is noticeable, which could be less than, but as much as, a cup size or more. Bottom line: breast asymmetry is common. “There isn’t any clear data to tell us how many women have cosmetic breast asymmetry of greater than one cup size,” says Dr. Malan, but some estimates run as high as 10 percent or more.
The embarrassment of breast asymmetry can affect women’s daily lives, sexuality and confidence, but for those with significant asymmetry, studies have shown that breast surgery can considerably elevate quality of life and self-esteem.
Breast asymmetry is sometimes a genetic issue, but not always. In fact, most of the causes of breast asymmetry are unknown. “Virginal asymmetry, which is a genetic predisposition, occurs during pubertal changes when one breast undergoes normal pubertal changes and the other breast does not,” Dr. Malan says. “A woman with virginal asymmetry might have one breast that is an A cup and another that is a D cup.”
Another cause of asymmetrical breasts is tuberous abnormality, which occurs when glandular tissue in one breast does not develop like it does in the other. As a result, a woman might have one smaller, malformed breast. In most cases of breast asymmetry, however, women’s breasts are shaped normally on both sides but one is smaller.
That was the case with 59-year-old patient Jan Kuykendall of Coulterville, Calif. At 5-foot, 3-inches she had 44 DD cup-size breasts, with one significantly larger than the other. She says it was hard not to bulge over the rims of any bra, especially on the one side. For breasts like Jan’s that are normally shaped but differ in size, the tried-and-true method is augmentation, using an implant (or fat transfer) for the smaller side to create greater volume and symmetry, according to Modesto, Calif.-based Theodore Staahl, MD, president of the California Academy of Cosmetic Surgery. The other option, of course, is to reduce the size of the bigger breast.
Given his patient Jan’s proportions, a breast reduction—not an implant—was just what the doctor ordered. In her case liposuction of both breasts worked to create a nice balance, with 500 ccs removed from her right breast and 650 ccs removed from the left. Today, she says, her C cup-sized breasts are more proportioned to her small frame and are symmetrical.
What To Expect
The procedures to create breast symmetry usually can be done on an outpatient basis and generally require twilight or local anesthesia; however, some patients and their physicians prefer general anesthesia.
Prices vary according to which procedure best addresses a problem. Liposuction of a single breast would cost in the ballpark of $2,000 to $3,000; a unilateral breast implant or reduction might cost between $3,500 and $5,000; and fat transfer to the breast (which requires two procedures, liposuction plus the actual augmentation) can cost $5,000 to $7,000.
Women who have routine unilateral implants may have discomfort for about three to five days after surgery and must wear a splint to keep the implant in position for as long as eight to 12 weeks. The post-operative effects of breast reduction usually last 10 days or less, and sutures remain for the first two to three weeks. The recovery from a fat transfer is a bit faster, usually requiring 24 to 48 hours of downtime, though a special garment is typically worn for the first six to eight weeks after the procedure.
Once the recovery is over, however, discomfort is usually supplanted by elation. “I am so happy,” Jan says. “I told [Dr. Staahl], that as far as I’m concerned, this is probably the biggest thing that I’ve ever wanted. I felt like a freak. Now I feel like I blend into the crowd.”