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Khan Volume difference management in asymmetrical breasts

INTRODUCTION hand side. Group C included patients who presented
with breast asymmetry with ptosis and had same size
Breast and chest asymmetries are common and have implants on both sides with different volume breast
been documented in aesthetically perfect models as reduction on one side to correct asymmetry. Group
well as randomly selected females through public C was further divided into C1 and C2. C1 included
advertisement. [1,2] patients who had more tissue removed from right side
than the left and C2 included patients who had more
Randomly selected patients presenting for augmentation tissue removed from the left side.
mammoplasty had their preoperative pictures
retrospectively analysed by independent observers. [3] Statistical analysis
Breast and chest asymmetries also were prospectively The data were analyzed using the Statistical Package
recorded using detailed physical examination and for the Social Sciences (SPSS), version 19.0. The
measurements. Data was analysed and reported along results are presented in the text as frequency,
with the relative prevalence and distribution of the percentage for qualitative/categorical variable
larger side involved in these asymmetrical cases. All (smoking, difference in implant size) and mean ± SD
[4]
published articles in last 6 decades may have reflected for quantitative/continuous variables (age, implant
from different angle highlighting various aspect and size, and tissue removed, etc.). The statistical analysis
asymmetries of chest and breasts but one thing was was performed using the Chi-square test of proportion
commonly shared by all these authors was that breast for the comparison of qualitative/categorical variables
and chest asymmetries are very common. However and the t-test for the comparison of quantitative/
there is a lack of information on different volume continuous variables. A P-value < 0.05 was assumed
implants used or different volume reductions performed to be statistically significant.
for the management of these asymmetries when these
patients presents for augmentation mammoplasty
or one stage augmentation mammoplasty with RESULTS
mastopexy. The current article highlights volume
management in 278 such patients who had different Since 2005, 1,450 patients had augmentation
size implants or different weight tissue resection for mammoplasty and 150 patients had augmentation
asymmetry correction. mammoplasty with mastopexy in muscle splitting
biplane pocket. Of these 1,600 patients, 278 patients
METHODS presented with significantly noticeable asymmetry and
were operated for augmentation mammoplasty alone
In current study for breast volume difference or augmentation mammoplasty with mastopexy.
management, retrospectively collected data was
analysed. All patients had round cohesive gel textured Group A
implants placed in muscle splitting biplaner pocket and Of 1,450 patients who had augmentation
single surgeon consecutively performed all surgeries. mammoplasty alone, 240 patients presented with
Patients presenting with breast asymmetry requiring significantly noticeable breast volume asymmetries
different size implants alone, mastopexy with different without noticeable nipple level asymmetries or ptosis.
size implants and same size implants with different Mean age of patients was 29.3 ± 7.9 years (range
breast volume reduction for mastopexy were selected. 18-53 years). Mean size of the implant on the right
side was 343.4 ± 66.2 mL (range 200-605 mL) and
The patients were divided into 3 groups. Group A the mean size of implants on the left side was 352.9 ±
included patients who had volumetric difference 86.5 mL (range 170-655 mL). There was no statistical
without ptosis and were treated with different size difference when mean implant size of symmetrical
implants alone. Group A was further divided into A1 augmentation mammoplasty was compared with
receiving larger of the 2 implants on the right side mean implant size used on right or left side in patients
and A2 receiving larger of the 2 implants on the left with asymmetrical breasts (P = 0.650 and 0.052
side. Group B patients included who had volumetric respectively) [Tables 1 and 2].
difference along with breast ptosis or nipple level
difference. The group was treated using different This group was further divided into A1 and A2.
size implants for volume correction with similar size Subgroup A1 included 145 patients who had larger
tissue resection for mastopexy. This group was further implants placed on right side. In this group of patients,
divided into B1 and B2. B1 included patients who had mean implant size used on the right was 358.6 ± 63.3 mL
larger size implants on the right hand side and B2 as compared to 317.0 ± 62.5 mL on the left side.
included patients with larger implants placed on the left Subgroup A2 included 95 patients who had larger
Plastic and Aesthetic Research ¦ Volume 4 ¦ July 19, 2017 109