Breast *Fixes*- Size, Shape & Symmetry

The following comments are all real. They represent the concerns of many women, about their breasts.


“ They’re different sizes. They’re different shapes. They’re too far apart. They’re too small. They’re too big. They’re sagging. They’re ‘tubular.’

Although Breast Augmentation remains the most popular cosmetic surgical procedure in America today,  Breast Surgery is about so much more than a desire for a larger, fuller appearance. This discussion addresses other, corrective measures for your breasts.Women of all ages experience breast abnormalities, and changes. Some breast concerns are congenital; with size, shape, and position determined by genetics. Some are the result of physiological or age-related changes, or injury.

In the Before & After photo set below, the patient was bothered by considerable loss of volume in her breasts, following pregnancy. She chose to have a Breast Augmentation with implants.

In addition to concerns about small breasts, and proceeding on the assumption that there are no underlying medical or health concerns, here are:



BREAST ASYMMETRY: This diagnosis is so common, it can be called a normal complaint. Breasts are rarely an exact match. But often, the differences are noticeable, and bothersome. Some women have great difficulty and emotional distress caused by the uneven appearance of their breasts. Many who’ve compensated over the years, with padding and creative undergarments to make their breasts look even under clothing, tire of the mechanics involved in daily dressing, and choose a more permanent solution.

Young women, whose breast development has just completed, can have considerable problems emotionally, with the dissimilarity. Recent studies have shown a pronounced improvement in emotional well-being, for young women who’ve undergone corrective procedures. Societal pressures, including fashion and body image, have a definite effect here, and especially at this age.

Many women are well into adulthood, parenthood, and beyond when they decide to seek help for their uneven breasts.

THE FIX: Each patient, of course, will have a different set of circumstances. For many women, Breast Augmentation with Implants can provide the results they want. Implants can be sized differently, to accommodate each breast. In some cases, Fat Grafting may be used as well. If the breasts, or breast, are sagging or the nipple position is high or low – Breast Lift surgery (Mastopexy) may also be recommended.

BREAST SAGGING (PTOSIS): Weight loss, weight gain, pregnancy, larger breasts, age, smoking, and skin laxity- are all factors that can cause breasts to sag over time. Gravity happens to everyone. Our skin and tissues loosen as we age.

THE FIX: Many patients believe that “filling” the sagging or excess skin with an implant will be sufficient to bring the breast back to its former, perkier self. Sometimes, this is a reasonable option. But very often, Breast Augmentation along with a Breast Lift will be the better option. Breast Augmentation will restore volume, and Breast Lift will restore position by removing excess skin and tissue, and realigning the nipple.

Breast Lift by itself, without an implant is also a possibility.   A note to remember- It often happens that women who’ve undergone a simple Breast Lift (no implant), will see a reduction in their breast and bra size, once the extra tissue has been removed.

TUBEROUS BREASTS: Many patients also use the term “Tubular” breasts to describe this concern. A tuberous breast often has a smaller, “narrow,” underdeveloped base. Even though the breast itself may be small, the position of the breast crease may be relatively high, causing the breast to hang, or droop downward. In addition, the nipple and areola may have a puffy appearance. Asymmetry and malposition of the breasts is also commonly seen.

THE FIX: With the multiple issues mentioned above, a plan needs to be developed to best address the patient’s concerns. Breast Augmentation may be involved, along with possible procedures to adjust the breast capsule. A Breast Lift and nipple/areola repositioning, or resizing may also be options.

MACROMASTIA (LARGE BREASTS): Women with overly large breasts may have a long list of physical and emotional problems associated with the condition. These include pain in the upper back, neck, upper arms, shoulders, bra-strap grooving, rashes beneath the breasts, and great discomfort with many physical exercises.

In addition, many women with large breasts have associated emotional trouble; self-consciousness, embarrassment, difficulty in relationships, as well as difficulty finding appropriate types of clothing.

The problems are real, and recognized. In many cases, health insurance will cover surgeries to reduce overly large breasts.

THE FIX: Breast Reduction Surgery (Reduction Mammaplasty) is the recommended procedure. Excess tissue and skin are removed during the surgery, and the breasts are reshaped and lifted.

In all of the “Fixes” listed here, the solutions described are surgical. Please make it a point to understand all of the risks and benefits associated with the procedures, and choose a Board Certified Plastic Surgeon.

Our many patients who have undergone the various Breast Surgeries described, report being highly satisfied with their results. Beyond the improved aesthetic appearance, they list benefits including pain relief, greater self-confidence and self-image, as well as lifestyle improvement.

[Dr. Vincent Lepore is a Board Certified, Stanford-trained Plastic Surgeon in San Jose, California. He has extensive expertise in Cosmetic and Reconstructive Breast Surgery, along with a full range of Body and Face procedures. Please call to schedule a Consultation – (408) 356-4241]

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