Pediatric and adolescent breast asymmetry

What is pediatric and adolescent breast asymmetry?

While some degree of breast asymmetry (asym·​me·​try), or difference in size and shape between the two sides, is present in most females, breasts can occasionally develop significantly differently. When this difference reaches the point at which it is difficult to find underwear that fits, if there is neck, shoulder or back pain due to the difference in weight between the two sides or when the woman has psychosocial consequences from the difference between the two sides, then women may choose to seek treatment for breast asymmetry.

In-depth look of pediatric and adolescent breast asymmetry

Almost all females have a degree of asymmetry of their breasts, either in size, shape or ptosis, which is the degree of droopiness of the breast. Breast asymmetry that is more than a cup size difference can cause physical problems including poor posture, pain in the back, shoulders or neck and psychosocial problems such as poor self esteem, unwillingness to undress in front of others, being teased by peers, difficulty finding underwear that fits comfortably, and difficulty with relationships.

Underlying conditions

When assessing a patient for breast asymmetry it is important to look for other conditions that can affect breast development on one side, such as Poland’s Syndrome and to assess for an asymmetry of the underlying chest wall. It is important to ensure that the breasts have reached their final developmental size, as any surgery undertaken while the breasts are still developing can result in good initial symmetry but any further breast development can make the breasts, once again, asymmetrical.

Weight

Overall weight is also important. If you gain weight, it will alter the size and shape of your breasts, and these changes may not be the same on both sides so, gaining or losing weight after any surgery to correct asymmetry is likely to change the outcome from your procedure.

Breast changes

It is also important to appreciate that breasts change during your whole life, especially during and after pregnancy, and any technique to correct breast asymmetry can give good results to start with, but these results can worsen as your breasts change naturally.

There are, however, certain techniques that are more resistant to this than others. In addition, any young woman undergoing insertion of breast implants is likely to outlive those implants and so should expect further surgery to replace her breast implants or to correct any complications from implants over the years.

Size preferences

There are many types of breast asymmetry but these are best thought of as how the breasts are compared to what the woman would, ideally, like.

• Some women prefer the larger breast and would like the smaller one made larger to match.

• Others prefer the smaller and would like the larger breast reduced to match.

• Others would like a middle ground between the two.

• Others who have a difference in the ptosis of their breasts, would like a breast lift on the more ptotic side together with enlargement or reduction of one or both.

What are signs and symptoms of pediatric and adolescent breast asymmetry?

There is no lab test for breast asymmetry and diagnosis is made usually by the patient themselves and confirmed by clinical examination. More important than the diagnosis is the assessment of how the breasts are different and which operation or sequence of operations is the best way to treat the condition for the individual patient.

How is pediatric and adolescent breast asymmetry treated?

When treating breast asymmetry in children and young women, it is important to realize that, even in the same person, breasts can develop at different ages, so it is important to wait until the natural breasts have developed prior to planning surgery to correct any breast asymmetry.

We offer a personalized treatment to take into account not only the extent of the condition and how the individual patient is affected, but also to look ahead to how that young woman will grow and develop over time.