Correction of asymmetry in breast surgery


Correction of Asymmetry in Breast Surgery

Symmetry has long been held to be a hallmark of physical beauty, for the face and the body. It’s more than just an artistic concept; scientific studies have consistently validated the relationship of symmetry to attractiveness. Yet we all know that there is no such thing as an absolutely symmetrical face or perfectly symmetrical breasts. In its original meaning, symmetry was not just a geometrically perfect mirror image but a general sense of harmonious and beautiful proportion. That is our goal with aesthetic surgery, but obvious differences from one side to the other do need to be addressed.

3D imaging with VECTRA Helps Analyze Causes of Asymmetry

The introduction of 3D imaging with VECTRA has demonstrated that asymmetry exists even when it is not obvious to the naked eye and that it often involves several factors.

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This is particularly evident in breast surgery, whether for reconstruction or enhancement. Patients may notice that one breast is larger, but it may be that the breasts actually have similar volume but the rib cage is more prominent on one side. Nipple position and size may vary, the bottom edge of one breast (inframammary fold or IMF) can be higher or lower, or breast shape may be different. Usually, it is a combination of all of these things.

Rotating the 3D image helps to reveal the specific anatomic variations in each individual and to develop a plan. For example, the patient in the first example actually has close to equal sized breasts, but one looks smaller. The tilted view (as though you are looking from the bottom up) shows that this is related to a more prominent rib cage on the right side. Simulations with a 265 cc implant on the right and 286 cc's on the left show that the projection is about the same even though the breasts will have different volumes. The actual results have the illusion of greater symmetry. 

In the second example, the nipple position is lower on the right side. The VECTRA tilt view shows a fairly symmetrical rib cage. This patient had the same size implants placed, and a crescent lift on the right side (removal of a crescent of skin along the upper edge of the areola.)

In the third example, multiple asymmetries exist: size, shape, and nipple position. In this instance, one breast was reduced, and both were lifted with a Galaflex internal bra. There are still some differences but a general appearance of symmetry. The Galaflex helps maintain the shape over time.