Unequal Breasts Treated by Breast Implant & Uplift

Asymmetry of the breasts is very common and affects many women.  Mr Richards shows how this can be treated with a combination of Breast Enlargement (Augmentation) with silicone implants and different types of Breast Uplift (Mastopexy) procedures.

Unequal Breasts Treated By Breast Implant & Uplift

Hello, my name is Adrian Richards. I’m a plastic and cosmetic surgeon based here in the United Kingdom. Today, in this video, I’m going to be showing you an operation that I did today on a lady with a very asymmetrical bust. The right side, as you’ll see in the preoperative photographs, is larger than the left and the nipple is in a lower position. So I’m going to perform a reduction on the right, lifting the nipple up to a higher position and an uplift, only, on the left preserving the volume of the bust. So I’ll be taking you through the operation, step by step and I hope you’ll find it useful and informative.

So here’s our patient, and you can see that her right breast is considerably larger than her left with a nipple in the lower the position on that right side. So on the right, I’m going to be performing a uplift with a vertical scar because the nipple needs to go up a larger distance. Whereas on the left, I’m just going to be performing a technique with a periareola reduction where the scar is just around the nipple. I’m going to reduce the size of the areola on both sides. Because the left nipple needs to go up less, I’m just going to be performing the scar around the nipple, whereas on the right, it’s going to be a vertical scar.

You can see this is the first stage in the operation is to put some local anaesthetic in the plane underneath the breast and then to remove this top skin is a technique known as de-epithelialisation, which is essentially just removing that top skin, leaving the deep layers of epithelium there.

The next stage is to cut through the skin there, and then I’m going to create the pocket, as you can see there, and that’s where the implant is going to be inserted. Before I insert the proper final implant, I put a temporary inflatable implant in position here and I’m going to blow that up with my syringe. That will show me the optimum fill volume of the final implant.

So I can slowly blow it up. I can see the tension in the breast. See when the cleavage is nicely formed, and then when I get my optimum volume, I’ll remove the temporary implant, put my antibiotics in like I’m doing and now clean the skin with iodine ointment to reduce any chance of infection of the area. Then I will put in the final implant of the volume which we have decided already from testing it with the inflatable implant.

So this is just a final implant going into the area here, and you can see that’s just put in through the hole, in this case, in front of the muscle. I’ve sewn the area up here. So I’ve got a good secure coverage over my implant. Now it’s really time to perform the uplift procedure.

So I’ve cut around the nipple and actually reduced significantly the size of the areola. This is me just taking the top layers of skin off from the area of skin I’m going to tighten up, and that’s where the nipple is going to raise to. So there’s the nipple and it’s going to be raised to that new position there as you will see in a minute, again, with the areola reduced. That’s the nipple elevated to the new position, and I’m just going to tighten up the lower part of the breast tissue.

So first of all, I remove this area of skin here. Then I’m going to use deep, buried stitches to sew up the deep layers of the dermis which I’ll show you in a minute. That will give support to the breasts, to really give firmness to that lower pole there. These are the deep stitches I was mentioning. So these are absorbable stitches. I don’t know if you can see how they’re sort of tightening up the skin, and they give really good deep support to the lower part of the breast to preserve the shape of the breast for as long as possible.

Here you can see the nipple in the new position there. All closed with absorbable stitches which are going to be trimmed flush with the skin one week following the operation.

The final layer is with Dermabond glue. So you can see here I’m just putting on some glue. It just really seals the wound so the patient can wash and so reduces the risk of any infection, any bugs getting in there.

Now on the other side, I’m going to insert the implant like I did on the left. So that’s into a pocket in front of the muscle on that side, behind the breast tissue and so that the nerve supply and blood supply to the nipple will remain in tact. I’m just going to perform a periareola lift on this side because the nipple doesn’t need to go up as much as on the left. Here I’ll remove that sort of doughnut of skin around the nipple, reduce the size of the areola, and then the nipple is going to be lifted up to this new position here and again closed all with absorbable stitches, the ends again, to be trimmed one week following surgery.

So thank you very much for taking the time to watch this video which I hope you found useful and interesting. If you would like any information on any other plastic procedure, please feel free to contact us, either via our website which is Aurora-clinics.co.uk or by phoning us directly, 01844 214362. Thank you.