Review of implant sizes in 146 consecutive asymmetrical augmentation mammoplasties
Breast and chest asymmetries have been reported with varying incidences in patients requesting augmentation mammoplasty. However, there is a paucity of information regarding the sizes of different implants used, their relative distribution on either side, complications and revision rates in this cohort when compared with primary augmentation mammoplasty using similar size implants.
A retrospective data using the Excel spreadsheet was performed. All patients had muscle splitting technique for augmentation mammoplasty in asymmetrical breasts. Patients requiring augmentation with mastopexy, sternal notch to nipple areolar complex level discrepancy of more than 1 cm, and patients having same size implants were excluded from the analysis. Insignificant asymmetries, not noticed by patients, were not chosen for two different size implants. Patients, who chose two different size implants for mammoplasty, were divided into three groups based on the relative difference in the size of different implants used.
A total of 164 patients had primary augmentation mammoplasty between 2005 and 2011, using two different size implants for augmentation mammoplasty in asymmetrical breasts. Mean age of the patients (n = 164) was 29.2 ± 7.79 years (range 18–50), and 46 (28.0 %) were smokers. Complete data on differential implant sizes used was available in 146 patients. Mean size of the implant on the right (n = 146) was 346.27 ± 70.581 cc (range 220–605). The mean size of the implant on the left (n = 146) was 333.46 ± 74.419 cc (range 200–655). Out of these 146 patients, 46 (31.5 %) patients had larger implants on the left as compared to 100 (68.5 %) patients on the right. Mean volume difference between the two sides when larger implants were used on left side was 55.76 ± 37.785 cc as compared to 44.35 ± 26.166 cc when larger implants were used on the right side. Low profile combination was used in 2.73 %, moderate size implant combination was used in 9.58 %, mixed profile combination was used in 3.42 % and high profile combination was used in 84.24 % of the patients. Overall revision surgery was performed in three patients (1.8 %), and out of these three revisions, only one (0.6 %) patient needed surgery for volume correction.
Primary augmentation mammoplasty in asymmetrical breasts using differential size implants is a procedure with low revision rates, provided that strict exclusion criteria are used along with adequate informed consent in this group.
Level of Evidence: Level IV, risk/prognostic study.
KeywordsBreast asymmetries Chest asymmetries Mammoplasty in asymmetrical breasts Muscle splitting breast augmentation
Conflict of interest
All patients gave their informed consent prior to their inclusion in this study.
- 2.Koch MC et al (2011) Breast volumetry using a three-dimensional surface assessment technique. Aesthetic Plast Surg 35:847–855Google Scholar
- 3.Gabriel A, Fritzsche S, Creasmen C, Baqai W, Mordaunt D, Maxwell P (2011) Incidence of breast and chest wall asymmetries: 4D photography. Aesthet Surg J 31:506–510Google Scholar
- 4.Gore SM, Lamberty GH (2012) PERTHESE implant-identical cohesive-gel sizers in breast augmentation: a prospective report on 200 consecutive cases and implications for treatment of breast asymmetry. Aesthet Surg J 32:310–318Google Scholar
- 5.Maxwell GP (2001) Breast asymmetry. Aesthet Surg J 21:552–561Google Scholar
- 6.Becker H (2000) Adjustable breast implants provide postoperative versatility. Aesthet Surg J 20:332–334Google Scholar
- 10.Reilly AF (2006) Breast asymmetry: classification and management. Aesthet Surg J 26:596–600Google Scholar
- 11.Arco A, Gravante G, Araco F, Gentile P, Castri F, Delagu D, Fillingeri V, Cervelli V (2006) Breast asymmetries: a brief review and our experience. Aesthetic Plast Surg 30:309–319Google Scholar
- 12.Khan UD (2009) Breast augmentation in asymmetrically placed nipple areolar complex in horizontal axis: lateralisation of implant pocket to offset lateralised nipples. Aesthetic Plast Surg 33:591–596Google Scholar
- 13.Rohrich RJ, Hartley W, Brown S (2005) Incidence of breast and chest all asymmetry in breast augmentation: a retrospective analysis of 100 patients. Plast Reconstr Surg 48:229–237Google Scholar
- 15.Khan UD (2007) Muscle splitting breast augmentation. A new pocket in a different plane. Aesthetic Plast Surg 31:553–558Google Scholar
- 16.Khan UD (2013) Muscle splitting, subglandular and partial submuscular augmentation mammoplasties: 12-year retrospective analysis of 2026 primary cases. Aesthetic Plast Surg 37:290–302Google Scholar