Uneven breast shape? Questions for PD Dr Mathias Tremp

Breast
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Most women have asymmetrical breasts. Unequal sizes or even different shapes of the breasts are normal. The position of the nipples can also vary from breast to breast.

If the differences and asymmetries of the breasts are very large and the woman suffers from them, a breast correction may make sense. PD Dr Mathias Tremp answers frequent questions from the breast consultation.

How common is an uneven breast shape?

An asymmetrical or uneven breast shape is very common and occurs in practically every patient. Very rarely can symmetry be achieved with a simple breast augmentation, but additional measures are needed to achieve symmetry.

What methods can be used to even out the shape of the breast?

If there is a significant difference in breast volume, a different implant per breast can be used to achieve symmetry. There are drop-shaped or round implants. Which implant is ultimately used above or below the muscle is decided individually and must be harmonised with the patient’s wishes.

What are the options if the breast is a bit saggy?

If the breast is also somewhat sagging, then a lift should be performed at the same time as the breast augmentation. If the breast is discreetly sagging, the lifting can be done from the inside (“inner lifting”), if the breast is clearly sagging, the lifting must be done from the outside either around the atrium or with a so-called T-cut with a vertical scar up to the underbust fold.

What other options are there for correcting an uneven breast shape?

Another very popular option is fat grafting. Fat can be suctioned from several regions and injected into the breast. The fat is not injected into the mammary gland, but either into the muscle or over the glandular tissue under the skin.

What is a tubular breast?

A tubular breast is caused by regions of the breast developing differently. The breast appears small, misshapen and resembles a “tube breast” or “trunk breast”. Often there is also a raised underbust fold and an oversized, protruding areola.

How is the “tube chest” corrected?

The tube breast is relatively common. Correction consists of remodelling and shaping of the glandular tissue. The underdeveloped glandular body is compensated with an implant.

Is there a cancer risk with implants or with autologous fat treatment?

Recently, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has been the subject of increased discussion. This is a rare form of cancer that should not be confused with breast cancer. There is a possible connection between BIA-ALCL and breast implants, but nothing has been proven to date.

The exact cause of BIA-ALCL is unclear. It is suspected that the surface structure of the breast implants plays a role: according to this, implants with a textured surface are more frequently associated with BIA-ALCL than smooth-walled implants.

Today, autologous fat treatment is considered safe with regard to breast cancer and further follow-up examinations for screening are also possible after treatment.

How long will I be unable to work?

Yes, depending on the extent of the operation, between 7-14 days

When can I do sports and shower again?

Showering is allowed after 48 hours, physical activity is possible again after 4 weeks.

Do I have to wear a special bra after the operation?

After the operation you will need to wear a tight-fitting bra for 8 weeks.

What are the risks?

Possible risks are infections, secondary bleeding, capsular contraction or unsightly scarring. There is a feeling of numbness at the beginning, but it usually returns to normal after 6 months. In addition, minor corrective operations are often necessary in the further course.

What are the costs?

The costs for an operation are agreed in advance depending on the duration and severity of the operation. In the case of pronounced congenital malformations of the breast, the health insurance fund may be able to cover part of the costs, this must be checked individually.

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