Breast asymmetry

You’ve probably heard the phrase “Breasts are sisters, not twins.” Most women don’t have perfectly symmetric breasts, but usually the asymmetry is mild enough that it is not apparent unless you are closely analyzing a medical photograph, or taking detailed measurements. But there are a few situations where you may want to do something about breast asymmetry. For example, if the asymmetry is significant, you may find that it is readily apparent to you even when you are fully clothed. Or you may notice that it is difficult to find a bra or swimsuit that fits both breasts well. If you have already undergone a breast surgery (such as a breast augmentation, lift, reduction, or reconstruction), you may find that a minor asymmetry is magnified by the surgery, and becomes more bothersome to you.

During your consultation, you should expect to discuss your overall medical history. This includes breast health history (e.g., prior mammograms and family breast history), prior surgeries, and medications and supplements you use. After meeting Dr. Nagarkar and his nurse, you will also have medical photographs taken in the office to assist with the surgical planning.

Dr. Purushottam Nagarkar, University of Texas Southwestern Medical Center, Dallas, Plano and Frisco
Dr. Nagarkar on his philosophy of breast asymmetry surgery:

Breast asymmetry and revision breast surgery takes a bit of detective work. It is not always clear what is causing the asymmetry – it can be the ribcage, abnormal breast development, scar, asymmetric positioning of a breast implant, and any number of other possibilities. The good news is, a combination of photo analysis, measurements and a detailed examination will usually reveal the underlying cause. Correction of breast asymmetry requires all of the skills inherent to plastic surgery – the surgeon must have knowledge of a wide range of techniques, a creative problem-solving approach, and the ability to think on his or her feet. It’s another great example of my core philosophy – there are no cookie-cutter solutions in plastic surgery.

Who is a good candidate for breast asymmetry correction:

Most patients without any major medical problems and without a history of breast cancer can be good candidates for this surgery. But the most important aspect of this surgery is ensuring that your goals and expectations are clear and realistic. You should plan on having a frank discussion with Dr. Nagarkar on your vision of your final result.

How to prepare for surgery:

Dr. Nagarkar will let you know if any laboratory tests are required prior to your surgery. In many patients, a pre-operative mammogram may be needed to obtain baseline information and help detect any changes in your breast tissue. If you are a smoker, you must completely stop smoking and refrain from any nicotine-containing smoking cessation aids (such as patches or gums) for 6 weeks before and after surgery. This is critical as smoking increases the risk of significant complications. Finally, you will discuss with Dr. Nagarkar which medications and supplements you should stop taking before surgery, and which ones you can continue. You will get detailed written instructions for pre- and post-operative care. In addition, you will receive any postoperative prescriptions you might need so that you can have them filled by your pharmacy in advance.

What to expect on the day of surgery:

Breast asymmetry correction or revisions are generally outpatient surgeries that last around two hours. The exact time depends on the complexity of the case, and whether you have multiple procedures performed. You should plan on having nothing to eat or drink after midnight the night before surgery. You will need to have someone drive you to and from the surgery, and to stay with you for 24 hours afterwards. If you had several procedures performed at the same time, you might need to stay overnight in the hospital for observation. A licensed and certified anesthesiology provider will be present during your procedure to provide anesthesia and monitor you at all times during the surgery.

What to expect after surgery:


Your surgery is designed and performed to achieve as close to 100% symmetry as possible on the operating table. Unfortunately, in the first 24 to 48 hours after surgery, significant swelling occurs, and this is often asymmetric in nature. It will take 2 to 3 months for the swelling to resolve and for you to see your final result. Your scars may appear raised, and inflamed at first, but will fade, soften, and flatten, over the course of 6 months to a year after surgery.

The first few days

Recovery after breast asymmetry correction is usually quite rapid. You will be able to go home after surgery, and that evening it is critical that you are up and out of bed and walking. This reduces your risk of forming blood clots in your legs. Dr. Nagarkar will call you the next day to make sure you are doing well, and to answer any questions you might have.


Narcotic pain medications are usually only needed for a day or two, and often are not required at all. Often, anti-inflammatory over the counter medications like Tylenol and Ibuprofen are adequate.

Incision care

Your incisions will all be closed with internal absorbable sutures, and surgical glue, so you can generally start showering the day after surgery, although bathing, swimming, or getting in a jacuzzi should not be done until at least 3 weeks after surgery. You may have a surgical bra to support the breasts that you should wear for the first 6 weeks after surgery, whenever you are up and about. You should protect your fresh scars from sun exposure for at least 6 months after surgery, because they are extra sensitive to sunlight during this period. Dr. Nagarkar may discuss special scar care techniques such as silicone sheeting or moisturizers with you. If you are prone to forming keloids, it is very important that you discuss this with him prior to your surgery.


Most patients do not require surgical drains.


You can return to your regular diet after surgery, but for the first day or two, stick with lighter meals. Anesthesia can make your digestive system a bit sensitive – a double cheeseburger right after surgery is not recommended. You should refrain from high-sodium foods. Salt may increase swelling or prolong the time required for your swelling to resolve.


Recovery after breast asymmetry correction is usually quite rapid. Most patients only need to take a few days off work.


You will be able to go back to non-strenuous activities such as walking, using a computer, writing, and so on, immediately after surgery. You should not lift anything over 10 pounds (or a gallon of milk), for 2-3 weeks after your surgery to allow your tissues to heal.


You can resume driving once you are no longer taking narcotic medications, and when you feel that you are in full control of your car. This often takes a week or two.


Aerobic exercise such as yoga, running, cycling, barre, etc., must be stopped for three weeks to allow the tissues to heal. Strenuous activity too early in the recovery brings a high risk of bleeding, which can cause significant complications.

Follow-up visits

You will see Dr. Nagarkar in the office usually 7 – 10 days after surgery to examine your incisions and healing progress. We will see you again at 4-6 weeks, and Dr. Nagarkar may clear you from activity restrictions at that time. Finally you will have appointments around 3 months, 6 months and 1 year after surgery.

To meet Dr. Nagarkar in person, schedule your consultation or call us.