Aesthetic Plastic Surgery

, Volume 30, Issue 3, pp 309–319 | Cite as

Breast Asymmetries: A Brief Review and Our Experience

  • A. Araco
  • G. Gravante
  • F. Araco
  • P. Gentile
  • F. Castrì
  • D. Delogu
  • V. Filingeri
  • V. Cervelli


The authors describe their personal experience with the management of mammary asymmetries. A review of their database from January 1998 to January 2005 identified 177 patients with idiopathic breast asymmetries. All these cases had been classified previously into six groups. Bilateral asymmetric hypertrophy and unilateral hypertrophy were treated with reduction mammaplasty. Unilateral hypertrophy with amastia or hypoplasia of the contralateral side was managed with reduction and augmentation mammaplasty. Unilateral amastia or hypoplasia (Poland’s syndrome) was treated with a single monopedicle transverse rectus abdominis muscle (TRAM) flap, and asymmetric bilateral hypoplasia was managed with augmentation mammaplasty. Unilateral mammary ptosis was treated with mastopexy and augmentation mammaplasty. The proposed classification, derived from the authors’ experience in this field, gives an idea of how they usually treat these patients. It is useful for a first evaluation, but after that, every treatment must always be individualized on a patient-by-patient basis.


Aesthetic breast surgery Breast asymmetries Reconstructive surgery 


  1. 1.
    Argenta LC, Vanderkolk C, Friedman RJ, et al. Refinements in reconstruction of congenital breast deformities. Plast Reconstr Surg 76:73–82, 1985CrossRefPubMedGoogle Scholar
  2. 2.
    Beer GM, Kompatscher P, Hergan K: Poland’s syndrome and vascular malformations. Br J Plast Surg 49:482–484, 1996CrossRefPubMedGoogle Scholar
  3. 3.
    Clough KB, O’Donoghue JM, Fitoussi AD, et al. Prospective evaluation of late cosmetic results following breast reconstruction: I. Implant reconstruction. Plast Reconstr Surg 107:1702–1709, 2001CrossRefPubMedGoogle Scholar
  4. 4.
    Edstrom LE, Robson MC, Wright JK: A method for the evaluation of minor degrees of breast asymmetry. Plast Reconstr Surg 60:812–814, 1977CrossRefPubMedGoogle Scholar
  5. 5.
    Elliot RA Jr, Hoehn JG, Greminger RF: Correction of asymmetrical breasts. Plast Reconstr Surg 56:260, 1975CrossRefPubMedGoogle Scholar
  6. 6.
    Fischl RA, Rosenberg I, Simon BE: Planning unilateral breast reduction for asymmetry. Br J Plast Surg 24:402–404, 1971CrossRefPubMedGoogle Scholar
  7. 7.
    Fujino T, Harasina T, Aoyagi F: Reconstruction for aplasia of the breast and pectoral region by microvascular transfer of a free flap from the buttock. Plast Reconstr Surg 56:178–181, 1975CrossRefPubMedGoogle Scholar
  8. 8.
    Giacalone PL, Bricout N, Dantas MJ, et al. Achieving symmetry in unilateral breast reconstruction: 17 years experience with 683 patients. Aesth Plast Surg 26:299–302, 2002CrossRefGoogle Scholar
  9. 9.
    Gliosci A, Presutti F: Asymmetry of the breast: Some uncommon cases. Aesth Plast Surg 18:399–403, 1994CrossRefGoogle Scholar
  10. 10.
    Goyal A, Mansel RE: Iatrogenic injury to the breast bud causing breast hypoplasia. Postgrad Med J 79:235–236, 2003CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hawtof DB, Ram S, Alani H: Reconstruction of mammary hypoplasia associated with chest wall deformities. Plast Reconstr Surg 57:172–175, 1976CrossRefPubMedGoogle Scholar
  12. 12.
    Hoffman S: Recurrent deformities following reduction mammaplasty and correction of breast asymmetry. Plast Reconstr Surg 78:55–62, 1986CrossRefPubMedGoogle Scholar
  13. 13.
    Hueston JT: Surgical correction of breast asymmetry. Aust N Z J Surg 38:112–116, 1968PubMedGoogle Scholar
  14. 14.
    Jansen DA, Spencer Stoetzel R, Leveque JE: Premenarchal athletic injury to the breast bud as the cause for asymmetry: prevention and treatment. Breast J 8:108–111, 2002CrossRefPubMedGoogle Scholar
  15. 15.
    Lin KY, Nguyen DB, Williams RM: Complete breast absence revisited. Plast Reconstr Surg 106:98–101, 2000CrossRefPubMedGoogle Scholar
  16. 16.
    Marconi F, Gallucci A, Marra M, et al. Idiopathic unilateral hypoplasia of the breast. Minerva Chir 49:971–975, 1994PubMedGoogle Scholar
  17. 17.
    Martin B, Emory RE: Symptomatic macromastia in a patient with Poland syndrome. Plast Reconstr Surg 106:221–222, 2000CrossRefPubMedGoogle Scholar
  18. 18.
    Moher D, Schulz KF, Altman DG: The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 357:1191–1194, 2001CrossRefPubMedGoogle Scholar
  19. 19.
    Onesti MG, Mezzana P, Martano A, et al. Breast asymmetry: A new vision of this malformation. Acta Chir Plast 46:8–11, 2004PubMedGoogle Scholar
  20. 20.
    Planas J, Mosely LH: Improving breast shape and symmetry in reduction mammaplasty. Ann Plast Surg 4:297–303, 1980CrossRefPubMedGoogle Scholar
  21. 21.
    Radlauer CB, Bowers DG Jr: Treatment of severe breast asymmetry. Plast Reconstr Surg 47:347–350, 1971CrossRefPubMedGoogle Scholar
  22. 22.
    Rintala AE, Nordstrom RE: Treatment of severe developmental asymmetry of the female breast. Scand J Plast Reconstr Surg Hand Surg 23:231–235, 1989PubMedGoogle Scholar
  23. 23.
    Rohrich RJ, Hartley W, Brown S: Incidence of breast and chest wall asymmetry in breast augmentation: A retrospective analysis of 100 patients. Plast Reconstr Surg 111:1513–1519, 2003CrossRefPubMedGoogle Scholar
  24. 24.
    Sadove AM, van Aalst JA: Congenital and acquired pediatric breast anomalies: A review of 20 years’ experience. Plast Reconstr Surg 115:1039–1050, 2005CrossRefPubMedGoogle Scholar
  25. 25.
    Santi P, Berrino P, Galli A: Poland’s syndrome: Correction of thoracic anomaly through minimal incision. Plast Reconstr Surg 76:639–641, 1985CrossRefPubMedGoogle Scholar
  26. 26.
    Smith DJ Jr, Palin WE Jr, Katch V, et al. Surgical treatment of congenital breast asymmetry. Ann Plast Surg 17:92–101, 1986CrossRefPubMedGoogle Scholar
  27. 27.
    Steele SR, Martin MJ, Place RJ: Gynecomastia: Complications of the subcutaneous mastectomy. Am Surg 68:210–213, 2002PubMedGoogle Scholar
  28. 28.
    Trier WC: Complete breast absence. Plast Reconstr Surg 36:431–439, 1965CrossRefPubMedGoogle Scholar
  29. 29.
    Tvdek M, Kletensky J, Svoboda S: Aplasia of the breast reconstruction using a free TRAM flap. Acta Chir Plast 43:39–41, 2001Google Scholar
  30. 30.
    Urschel HC Jr, Byrd HS, Sethi SM, et al. Poland’s syndrome: Improved surgical management. Ann Thorac Surg 37:204–211, 1984CrossRefPubMedGoogle Scholar
  31. 31.
    Vandenbussche F: Asymmetries of the breast: A classification system. Aesth Plast Surg 8:27–36, 1984CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • A. Araco
    • 1
  • G. Gravante
    • 2
    • 4
  • F. Araco
    • 2
  • P. Gentile
    • 2
  • F. Castrì
    • 3
  • D. Delogu
    • 2
  • V. Filingeri
    • 2
  • V. Cervelli
    • 2
  1. 1.Crown House HospitalOldburiUnited Kingdom
  2. 2.University “Tor Vergata” of RomeRomeItaly
  3. 3.Department of AnesthesiaUniversity “La Sapienza” of Rome, S. Andrea HospitalRomeItaly
  4. 4.G. GravanteRomeItaly

Personalised recommendations