The Management of Breast Asymmetry
Significant breast asymmetry is not an uncommon problem and causes considerable angst and concern to women who have this problem. Treatment is complex as it involves a detailed assessment and making the right plans, as often there is asymmetry of size as well as shape. The volume discrepancy has to be corrected and then the shape improved. This may involve differential breast reduction and lift or breast augmentation and lift. While the correction of the problem is difficult, the end result is usually one that gives a lot of satisfaction and comfort to the recipient.
Before And After Results
Analysis of Patient
This 35-year-old lady had one pregnancy five years previously and did not plan any further pregnancies. She had bilateral breast hypertrophy and very significant asymmetry in size and shape. This was causing her significant physical and emotional distress, due to the obvious problem in most clothing and the difficulty in getting proper fitting clothes.
Treatment
June 2021
She needed bilateral differential breast reduction (removal of 490g on the right and 1035 g on the left). The breast lift involved the nipples (32 cm on the right and 37 cm on the left) elevated to 21cm on the right and 23cm on the left). In addition, the lateral displacement of the left nipple was also corrected.
March 2022
Revision surgery: minor surgery for “dog ear removal” at the lateral end on both sides.
October 2022
Post revision photos were done in October 2022.
Further improvement could be had with a mastopexy (reshaping and lifting of the breast) +/ - augmentation (volume addition). However, the patient was happy with the outcome and no further treatment was planned.
Why Choose Us?
Your breast procedure is in the safe hands of an internationally trained Specialist Plastic Surgeon with Dr. Chandran Arianayagam. During his career, the doctor has performed many breast-focussed procedures from his clinic in Coffs Harbour since it opened in January, 1995. In conjunction with this, he has operated and observed all over the world, in Australia, India, Malaysia, Canada , the United Kingdom and the United States.
Dr. Chandran Arianayagam’s qualifications include a Bachelor of Surgery and a Bachelor of Medicine while also being a Fellow of the Royal College of Surgeons of Edinburgh. The doctor has been granted Specialist status in Plastic Surgery by the Minister for Health of the Commonwealth Government of Australia and is a Corresponding Member of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.
From cosmetic and reconstructive surgery to laser and injection treatments, Dr. Arianayagam is an expert in many Plastic Surgery techniques. He places great importance on taking a detailed approach to ensure the complete comfort of all his patients. This includes plenty of discussions, adequate time and space and whatever else may be required to ensure all patients are comfortable with the decisions they make. With at least two consultations prior to treatment, all patients are well-informed about their chosen procedures.
Once you have made the decision to go ahead with the surgery and have chosen Dr. Arianayagam as your surgeon, you will also be offered the opportunity to speak to one of our patients who has the same procedure.
The whole team at PCLS Coffs Harbour are well-known for outstanding levels of in-patient and post-operative care. This not only ensures a high-quality of service, but also makes every procedure far less daunting. Nothing less than the best care from the initial steps through to a full recovery is accepted by Dr. Arianayagam and his team who are personally accessible throughout every patient journey.
Frequently Asked Questions
Any surgery will leave scars. But we make an enormous effort to make them as inconspicuous as possible, using fine stitches and positioning the incisions so the scars will be difficult to see once they fade.
The ability to breastfeed is only confirmed when breastfeeding is attempted. Breast augmentation does not interfere with the ability to breastfeed.
Breast implants do not last forever and may eventually need replacing. However, no plans are made unless there is a problem.
All implants have a slight risk of leaking. The chance of your implant leaking increases over time, and most implants that have been in place for 10 to 15 years will have some minor leakage. With high cohesive silicone gel implants, the leakage is usually minimal and not a problem.
There is a great deal of anxiety that breast implants may cause an increased incidence of CTD or breast cancer. A number of significant studies have now allayed these concerns, producing no evidence of increased risk of either disease with breast implants.
It is quite common for women in their 40s and 50s to undergo breast augmentation surgery and experience excellent results. In many cases, a typical age for a patient looking for this particular surgery is a woman in her 30s, especially post-children.
If you have been considering this operation, no matter your stage of life you are currently in, you should schedule a consultation to learn more about how it will apply to your situation and to find the best path toward achieving your chosen cosmetic goals. If not breast augmentation, you may be better suited to a different procedure that will still help to increase your confidence, looks, and happiness.
As with all surgical procedures, there will always be risks such as post-operative bleeding, allergic reactions, infection, deep vein thrombosis, and haemotoma.
There are also some risks and complications that are specific to breast augmentation including:
Capsular contracture
When an implant is placed in the breast, the body recognises it as a foreign substance and walls it off with a scar wall known as a “capsule.” In most women, these capsules are soft or slightly firm.
In a small percentage of women, the capsule becomes thickened and firm, causing distortion of the breast shape and discomfort. Further surgery is needed to correct this condition.
Altered nipple sensation
Most women having implant surgery will experience no change in nipple sensation. However, approximately 10% of patients experience a temporary reduction or loss of nipple sensation.
Dynamic distortion
In extremely fit and strong women, the implants are placed above the muscles to avoid distortion due to muscle activity.
Pain around the implant
Some women feel pain from the implant or scar tissue, putting pressure on a nerve. You may be prescribed a program of exercise, stretching and massage, and possibly anti-inflammatory medicines.
Tissue Breakdown
Sometimes the tissue in the breast area doesn’t heal properly because of pressure from the implant. This could happen because the network of vessels supplying blood to the tissue has been damaged during surgery or as a result of blood vessel damage from smoking or diabetes.
If this occurs, then the dead tissue will need to be removed, and the implant may also have to be removed.
Mammograms
Mammograms are to be avoided with breast implants as the examination is incomplete. An MRI (Magnetic Resonance Imaging) is used instead.
ALCL
Anaplastic Large Cell Lymphoma is a recently recognised problem after breast augmentation.
Worldwide, currently about 900 women have been diagnosed with a Lymphatic Malignancy.
This presents as pain and swelling in one breast, usually a few years after surgery. There is a collection of fluid around the implant.
This fluid is removed and sent for special tests. In most women, the results do not show anything to be concerned about and only symptomatic treatment is needed.
In an occasional patient, it may confirm ALCL and will require treatment. This problem has only been seen with textured implants.
In view of the small number of patients with the problem compared to the number of implants over the years and all over the world, it is considered a very small risk.
Dr Arinayagam, to reduce the risk further, since August 2018 only uses smooth, round implants.
Our Locations
There are several locations offered by Dr. Arianayagam for the consultation on breast augmentation. The high-level of patient care discussed above is accessible at each one via a skilled and knowledgeable team, hand-picked by the doctor himself. The PCLS Coffs Harbour staff will ensure total care from the minute you walk through the doors to the end of your procedure and recovery process.
The PCLS team can book your consultation, coordinate a care plan, and ensure you have all the information you require to be completely prepared for your procedure.
In addition to all of this, they will stay in touch throughout your recovery process to ensure you have the follow-up care you need. The locations serviced by PCLS include:
