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Asymmetric Breasts: They Are Sisters, Not Twins

I have treated thousands of women for various breast conditions and it wasn’t until recently that I learned how best to answer a patient when she asks why her breasts are not identical. While all humans value symmetry, there is nothing about the human body that is naturally perfectly symmetrical: eyes at different heights, the jaw tilted to one side, legs varying in length, and asymmetric breasts differing in size and shape. Mother Nature created beauty in humans, but it’s obvious that absolute symmetry was not the primary goal.

asymmetric breasts

Since most women aren’t born with perfectly symmetrical breasts, it’s a bit of a stretch to think that, after undergoing a breast enhancement of whatever type, your breasts will look perfectly symmetrical. There’s always something: off-centered nipples, difference in wideness or fullness, (laterally or vertically), or the height of the inframammary folds can even be different. What is a surgeon to do?

Imagine this: you can actually have two perfectly symmetrical breasts (rare) that still look different because the ribs below are shaped differently! When even the rib cage of most patients is asymmetrical, the foundation of the actual breast is also different, resulting in lateral asymmetry of anatomically symmetrical breasts.

The good news is that it’s actually possible to make asymmetrical breasts look more symmetrical with the help of various procedures including breast implants and plastic surgery alternatives. After all, plastic surgery comes from the Greek word plasticos, which means “to mold.” Whoever coined the term plastic surgery recognized that perfection is an elusive goal but can be achieved by “molding” things into a better shape.

How do I help a woman who has two different breasts and desires a breast augmentation? The first thing I would do is point out the differences. Shockingly enough, patients with obvious breast asymmetries often aren’t aware of them. Simply raising awareness makes it easier to accept that their breasts will be different after surgery as well.

As a surgeon, I do have options in molding asymmetric breasts into more similar shapes and sizes. I can use differently sized or shaped implants, I can use the implant to actually mold the new breast by massaging or placing pressure on the overlying tissues with the breast implant. This process is both active and passive. The implant beneath the natural breast alone will expand the skin. The active part involves moving or placing pressure on the implant to expand the skin. These are very powerful and effective techniques that are underutilized and not the subject of much discussion amongst plastic surgeons.

This is not to say that you or I should accept huge obvious differences in breasts. But for peace of mind, we should all assume that breasts are not perfectly symmetrical and this is expected and quite natural. Really talented surgeons will recognize these differences and work their magic to make two sisters look like identical twins!

— Robert Caridi, MD
Diplomate of the American Board of Plastic Surgery
Fellow of the American College of Surgeons (FACS)
Member of the American Society of Plastic Surgeons (ASPS)
Member of the American Society for Aesthetic Plastic Surgery
Founder of the Austin Gynecomastia Center

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