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Khan Volume difference management in asymmetrical breasts

Table 7: Relative incidence of larger volume implant when compared with the mean size implant (314 mL)
used on respective sides based on the volume of the used on the right side to compensate left larger breast
prosthesis used in asymmetrical breasts (B1). This also was noted that mastopexy requiring
Difference Implant bigger right Implant bigger left P augmentation mammoplasty, larger mean size
(mL) A1 (n = 145) A2 (n = 95) value implants in group B2 were used on the left side in 13
< 30 31 (21.4%) 20 (21.1%) 0.951 patients with a larger difference (80 mL) as compared
30-60 96 (66.2%) 38 (40.0%) 0.001 to 7 patients in group B1, where larger implant was
> 60 18 (12.4%) 37 (38.9%) 0.001
used on the right with smaller difference (64 mL) to
compensate larger breasts on the left side.
smaller left breast (mean volume 407.8 mL) as
compared to the volume of implant used on the right The weight of tissue resection was also analysed in
side to correct asymmetry when left breast is larger 18 patients (group C) presenting with noticeable breast
(mean volume 317.0 mL) [Table 3]. Similarly when left asymmetry requiring mastopexy with augmentation
breast is larger, only 12.4% patients had larger than mammoplasty. These patients had same size implants
60 mL implants on the right breast as compared to with more tissue removed from the larger side (> 20 g).
38.9% requiring more than 60 mL difference implant This was noted that when the breast was larger on
on the opposite side when right breast was larger. The the right side, the mean weight of the tissue removed
results again concurred with the previously published was 95 g more as compared to 56 g, when left breast
work [Table 7]. [14] needed reduction for symmetry. The result emphasize
that when the breast is larger on the right, it tends
As one would expect, patient requiring mastopexy to be relatively larger than patients presenting with
with augmentation mammoplasty have in general larger breast on the left side [Table 6].
or present with larger breasts than patients who
require augmentation mammoplasty alone. The latter Volume difference in asymmetrical breasts can be
group is generally hypoplastic as compared to those assessed preoperatively using 3D photograpgy or
[5]
patients requesting for augmentation mammoplasty retrospectively by analyzing the volume difference
and mastopexy due to excess breast skin and excess of the implants used on two sides in patients who
breast tissue accompanied with ptosis. It was expected presented with asymmetrical breasts and had
that relatively higher prevalence of larger breast be on augmentation mammoplasty without mastopexy. The
right than on left side. When the sizes of the implants volume difference can also be analysed in patients
in this group was analysed, it was noted that slightly who needed augmentation mammoplasty with
larger mean size implant (339 mL) was needed on mastopexy. In the latter group, volume difference of
left breast to compensate right larger side breast (B2) the implants can be analysed when two different size

A B C

D E F

Figure 4: (A-C) A 19-year-old patient presenting with breast hypertrophy, asymmetry and bilateral class C ptosis. Her right breast was
markedly larger than the left; (D-F) postoperative results 10 months following Wise pattern mastopexy with 230 mL round low profile
textured cohesive gel silicone implants. She had 173 g tissue removed from her right and 147 g tissue removed from her left breast
Plastic and Aesthetic Research ¦ Volume 4 ¦ July 19, 2017 113