Before surgery, patients undergo routine preoperative assessments including lab tests, breast imaging when necessary, and evaluation of medical history—especially regarding smoking, which must be discontinued weeks before the procedure. A key step is the assessment of asymmetry: whether it involves volume, shape, or position. In cases of volume difference, we always discuss patient preference—whether they feel more comfortable matching the smaller or larger breast. It is also essential to evaluate for congenital deformities, such as Poland Syndrome, which may influence the surgical approach.

For mild asymmetries in volume or contour, fat grafting (lipofilling) is an excellent option. Our technique—published in Plastic and Reconstructive Surgery—defines anatomical zones for optimized fat placement and integration. It is often used alone for subtle corrections or in combination with other procedures to refine results.

The choice of anesthesia depends on the extent of the procedure. For smaller corrections or fat grafting, we often prefer local anesthesia with sedation or epidural block, allowing for faster recovery and same-day discharge. For more extensive surgeries involving implants or breast reshaping, general anesthesia may be recommended for patient comfort and optimal surgical conditions.

While breast asymmetry correction can achieve significant improvement in shape, balance, and self-confidence, it is important to maintain realistic expectations. In cases of complex or severe asymmetry involving differences in volume, shape, and nipple position, a single surgery may not be sufficient. A second-stage procedure—such as minor adjustments in volume or scar revision—may be necessary to fine-tune the result. Full healing and stabilization of the breasts may take several months, and we always aim for the most harmonious outcome possible while respecting each patient's anatomy.

Breast implants are commonly used to correct volume deficits, especially when one breast is significantly smaller. In congenital cases or post-trauma/cancer reconstructions, implants can restore symmetry and improve balance. Implant choice and placement are tailored to each case to harmonize with the natural breast. When asymmetry involves breast position—such as one breast being more ptotic —a lift (mastopexy) may be indicated on one or both sides. If both breasts are large but uneven, a mammaplasty can resize both for better balance. These approaches can be combined with implants or fat grafting when needed.

After surgery, patients receive detailed guidance on wound care, compression garments, activity restrictions, and follow-up visits. Avoiding vigorous movement, pressure on the breasts, and sun exposure is crucial for proper healing. Results evolve gradually as swelling subsides and tissues stabilize, with final symmetry visible within a few months.