Breast Implants & Mastopexy for Breast Asymmetry

Differences between the sizes of each persons breast is very common. Plastic and Cosmetic Surgeon Adrian Richards of Aurora clinics explains and demonstrates how Breast Asymmetry can be treated with Breast Enlargement with silicone implants and a Breast Uplift also known as Mastopexy.

Breast Implants & Mastopexy for Breast Asymmetry

Hello. My name is Adrian Richards. I’m the Surgical Director of Aurora Clinics, based here in the United Kingdom. In this video, I’m going to be taking you through an interesting operation on a lady with a breast asymmetry. This is an operation I’ve just completed.

So essentially, she’s got unequal breasts, with the left being larger than the right and also the left nipple position is lower. So what I’m going to do I’m going to perform a bilateral breast augmentation because she’d like more volume. And I’m going to perform what’s called a periareolar mastopexy on the right because the nipple only needs to go up a little distance and I will be performing a short transverse scar mastopexy on the left because the nipple needs to go up a further distance. So this is a good case to illustrate the difference between the breast uplift or mastopexy techniques. The technique really depends on the breast and the amount of elevation required from the nipple.

So here’s our patient. As you can see, she’s got quite a lot of breast asymmetry with a much larger breast on the left side. And also the left nipple is in a lower position although the areolas interestingly are a very similar size. So on the right I’m going to perform a breast enlargement, with what’s called a periareolar mastopexy, and I’ll show you that in a minute.

Here we are actually in the operation, and you can see that I’ve marked the periphery of where the implant is going to go. And on the left I’ve also marked my excisions where I’m planning to make my scars. So a different mastopexy on that side.

So starting on the right, the first stage is to do the breast enlargement procedure, and I’m going to do that via the normal inframammary five centimetre incision. Now you can see I’m just dissecting the pocket out in front of the muscle in this case and just checking any blood vessels here. You can see the extent of my dissection.

Next stage is to put in a temporary inflatable implant which you can see here. So I put that in and then inflate the implant up slowly to really sort of ascertain the best volume to fill soft tissue on the lobe. Here I am just filling up slowly. This gives me really good control to check the fill volume. There’s my antibiotics going in. And this is the implant I’m going to use, which is a TRF520 implant on that side. So, because that side is the smaller side, I’m using a higher profile implant on that side. So that means essentially that the diameter is the same but it’s higher.

That was me just sewing up the scar, and now I’m going on to do the periareolar mastopexy. So I mark the periphery of the new areola and a temporary tattoo in the different quadrant of the nipple, as you can see. So I’m going to reduce the areola significantly, and this is the tissue I’m going to remove, as you’ll see in a minute. So this is the skin. I’ve just removed the skin from that sort of a doughnut-shaped area around the nipple and reduced the size of the areola. And the next stage is really just to sew that in with absorbable stitches and sort of purse string the outside skin in, as you can see there, around the nipple, all with absorbable stitches. These are just the final layer of absorbable stitches around, and we just need to trim those stitches, which I’m holding in the clips in my left hand, a week following the operation.

The final stage of the operation is really just to put some tissue glue on the incisions just to make them watertight so the lady can shower pretty much immediately.

Now turning to the left. Now, because there’s more skin excess on the left, I’m going to perform a short transverse scar mastopexy in this case. And you can see this is the area I’m going to perform the implant through. There’s the skin removed from that area. And the next stage is just to make an incision in that area there. So this is where I’m going to make my incision to put the implant in on that side. So just cutting through the tissue there and then I’m going to develop a plane underneath the breast tissue and insert a smaller, lower profile implant on that side, because remember this is the bigger side so I’m putting a implant with a similar diameter but less of a projection.

And then the next stage is just to sew up the incision here, again, all with absorbable stitches. These stitches are going to be gone within three months of surgery. And here I am just finishing off that closure so the implant is completely isolated from the skin.

There I am just marking my new areola, and you can see how much smaller the new areola is than the old areola. Here’s the skin removed from the top part of the area, and this is with the closure completed, again with absorbable stitches. But you’ll notice that the scar is quite different on the left side because of the excess skin in that area. Again, here are all the absorbable sutures which are going to be trimmed at a week.

And here we are at the end of the procedure just showing you good symmetry between both sides. And then the final stage is to put some brown tape on the areas, and then we’ll fit the lady with a surgical bra.

So thank you very much for watching the video. Thank you to the patient for allowing us to show it. I hope that sort of clarified up some of the issues about mastopexy and the different types. Essentially, there’s a periareolar, which I did on the right. There’s a transverse scar, which I did on the left in this case. And then there’s also a variety of just vertical scar mastopexies without the transverse scar, and they’re really used in cases in between the two breasts I did today. So I hope that’s made it slightly clearer, and I hope you’re less confused if you were confused.

If you would like any information about this form of surgery, any form of breast surgery, or any topic in plastic surgery, please feel free to contact us via our UK number 01844 214362 or by our website which is Aurora-clinics.co.uk. Thanks for watching.