Occasionally the breast is normally shaped but smaller (hypoplastic) in other situations one or both of the breasts is/are smaller and also shaped differently. Classically, the base of the breast is tighter (constricted) while the area around the nipple projects out too much. A range of deformities are seen so sometimes the breast is just a little tighter and smaller whereas some other breasts are much more constricted at the base and the nipple much more prominent giving a very abnormal appearance (Snoopy’s nose or tuberous breast).
Treatment depends on how severe the problem is and how much it affects you. Two problems need to be considered. Firstly, there is the volume of the breast which can be altered with a silicone implant or expander and secondly the projection of the nipple which may need to be reduced by removing a ring of tissue around the nipple to make the area flatter (donut mastopexy).
Mild – Breast augmentation with a standard silicone breast implant
Moderate – Breast augmentation as above plus release of the fibrous bands inside the breast (parenchymal scoring) through the same incision
Severe – Expansion of breast volume using a tissue expander with a buried port that can be filled with saline after the operation in the clinic. Reduction of the nipple/areolar complex with a donut mastopexy
A simple breast augmentation can be done as a day case and achieve results very quickly. If tissue expansion is required then the operation takes around same time but the increase in volume of the breast will be achieved over a number of weeks and a second operation usually required to convert to a formal breast implant at a later date. Reduction of the nipple may be performed before any expansion if very severe but may be done afterwards to reduce the chance of the scar stretching
Where ever possible, we try to avoid performing breast surgery, such as augmentation or reduction, on teenagers as they are still growing and developing. However, in this situation the lack of breast development coupled with the often severe asymmetry can make school life and changing for games very difficult. Therefore surgery can be justified as this early stage to help mimic the normal breast development before performing definitive surgery once growth has stopped.
This problem varies tremendously from person to person and can cause extreme distress at school or make intimate relationships a problem. Our breast reconstruction nurses will be able to help discuss the options with you as sometimes relatively surgery can make an enormous difference. We also have a counseling service that can provide some coping strategies to help deal with day to day issues and our surgeons can offer a wealth of experience and the full range of options in order to achieve the best possible results.
Please go through the information below in your own time to help your understanding of the options available.