Corrective methods for uneven breast shape? Questions for PD Dr Mathias Tremp

Breast
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An uneven breast shape is very common and can be psychologically very stressful. There are various correction options, which can often be combined. The most common methods include: Breast implants (teardrop-shaped, round or customised), own fat grafting, breast lift and shaping of the mammary gland.

When do I need an implant and when do I need a lift?

If the breast is only slightly sagging and volume augmentation is desired, a breast implant is usually sufficient. The breast can also be lifted by means of an “internal lift” using the dual plane technique.

If the breast is very saggy and the areola is clearly below the inframammary fold, an additional lift is required.

When do I need a teardrop-shaped implant and when a round implant?

As a rule, we use round and smooth implants, also to reduce the risk of the so-called anal plastic lymphoma (ALCL) to a minimum.

Is the autologous fat treatment sufficient for volume increase?

The autologous fat treatment is only suitable for a small increase in volume. A relevant percentage also dissolves in the next 6 months, which is why a second treatment may be necessary.

What techniques are available for a breast lift?

If the breast is only slightly sagging, a tightening around the areola is sufficient. If the breast is clearly sagging, a so-called I-cut method (Lejour technique) or anchor cut/T-cut method is necessary.

Can the autologous fat treatment be combined with an implant?

This technique can be combined well. Through the autologous fat treatment, the breast can be individually modelled and adjusted.

What is a so-called “tubular breast” (tube breast or trunk breast)?

The tubular breast form is one of the most common breast malformations. It is caused by a growth disorder of the glandular tissue and the lower part of the breast grows less than the upper part. Characteristic features are the large areolae and the tubular shape of the breast.

How is a tubular breast treated?

Various surgical techniques are possible and are often combined. Basically, the lower pole of the breast must be corrected and the mammary gland unfolded. If the areola is pronounced, it is also tightened.

If a relevant increase in volume is desired, an additional implant is recommended. The implant is often inserted behind the muscle, but this varies from person to person. If only a small increase in volume is desired, then fat injections are the method of choice. If the breast is also very saggy, a skin tightening procedure must be performed.

What is the incision for the correction of a tubular breast?

The incision can be made around the areola or in the crease under the breast. Very rarely, a so-called anchor incision is necessary if a relevant breast lift is to be performed.

What are possible complications?

Infections, wound healing disorders and bruising can occur, but are rare. Temporary numbness usually disappears after 6 – 12 months.

With autologous fat treatment, cyst formation (oil cyst) is possible if too much fat is injected.

What requirements do I have to meet and what is the healing process like?

If you smoke, you must abstain from nicotine for 4 weeks before and after the operation. Immediate mobilisation is desired after the operation, physical activities with light sweating is possible after 2 weeks. After 6 weeks you can resume physical activities in the chest area.

What are the costs?

In the case of a pronounced form of tube breast, the relevant health insurance fund may cover the costs of the operation. This must be checked individually. Often the correction of an asymmetric breast is a cosmetic procedure, the costs for surgery are agreed in advance depending on the duration and severity of the operation.

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