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Breast Lift and Breast Asymmetry

Breast Proportion

Breast proportion is a very personal criterion which can influence a woman’s general feeling of satisfaction with her body. While some women are thrilled with the size of their breasts, or at least satisfied, many others are disappointed with their natural assets. Ironically, there are a virtually equal numbers of women who feel their breasts are too big or too small. In the 90s and Noughties, the rounded obvious breast-look was  more popular, but now the majority of women just want to have lovely breasts that look natural and real

Both men and women develop breasts from the same embryological tissues. However, at puberty, female sex hormones, mainly estrogen, promote breast development, which does not occur in men, due to the higher amount of testosterone. As a result, women's breasts become far more prominent than those of men.  During pregnancy, the breast is responsive to a complex interplay of hormones that cause tissue development and enlargement in order to produce milk. Three such hormones are estrogen, progesterone and prolactin, which cause glandular tissue in the breast and the uterus to change during the menstrual cycle.

Each breast contains 15–20 lobes. The subcutaneous adipose tissue covering the lobes gives the breast its size and shape. Each lobe is composed of many lobules, at the end of which are sacs where milk is produced in response to hormonal signals.

The Breast: cross-section scheme of the mammary gland.
1. Chest wall
2. Pectoralis muscles
3. Lobules
4. Nipple
5. Areola
6. Milk duct
7. Fatty tissue
8. Skin

Actual breast size is rarely an important factor considered by most women for measuring body image satisfaction. RELATIVE SIZE is far more important, since it determines the size of the breasts in relation to the proportions of the body. Small breasts can look simply stunning on a lithe figure and large breasts might look comfortable at home on a larger, fuller frame. Small breasts on a big frame are not as flattering and often draw the comparison to a pear shape, while large breasts on a small or especially short frame can look cumbersome and bulky. PROPORTION is the key element which typically determines personal satisfaction with overall breast shape and size. The projection of breasts from the midline of the body should be the same as projection of buttocks.
Luckily, regardless of whether you feel that your breasts are too large or too small, there are solutions which might work well for you. Large breasts can be conservatively reduced through diet and exercise. However, some women might require the additional intervention provided by either breast liposuction or breast reduction surgery.

Approximately two years after the onset of puberty (a girl’s first menstrual cycle), the hormone estrogen stimulates the development and growth of the glandular, fat, and suspensory tissues that compose the breast. This continues for approximately four years[ until establishing the final shape of the breast (size, volume, density) when she is a woman of approximately 21 years of age.  About 90% of women's breasts are asymmetrical to some degree, either in size, volume, or relative position upon the chest. Asymmetry can be manifested in the size of the breast, the position of the nipple-areola complex (NAC), the angle of the breast, and the position of the inframammary fold, where the breast meets the chest.

Asymmetry of  Breasts

or about 5% to 10% women, their breasts are severely different, with the left breast being larger in 62% of cases. This is due to the breast proximity to the heart and a greater number of arteries and veins, along with a protective layer of fat surrounding the heart located beneath it. Up to 25% of women experience notable breast asymmetry of at least one cup size difference.

Treatment of Asymmetry is done my augmenting the smaller breast with fat grafting technique.   Or with liposuction of the larger breast with liposuction.

Breast Proportion and Placement
Many women are actually quite happy with the size of their breasts, but are disheartened by their placement. As we age, the effects of time and lifestyle related changes often play cruel tricks on our breasts, making them deflate, sag or simply flatten out. In these instances, women are more concerned with refreshing breast appearance and placement on their anatomy, than with changing their size.

For women with ptosis or placement issues, breast lift surgery may be the ideal solution. These mastopexy techniques are fast becoming some of the most sought after of all cosmetic surgery procedures due to their amazing results.

What is the correct bra size.

Breast size is typically quoted in bra size, which include measurements of the band and the cup. The band size is determined by measuring around the chest directly beneath the breasts and rounding the figure to the nearest inch. If the figure is even, add 4 inches. If the figure is odd, add 5 inches. The cup size is determined by measuring around the fullest part of the bust and rounding the figure to the nearest inch. Bra size, and consequently breast size, is determined by subtracting the band measurement from the cup measurement. Each inch represents one cup size which is expressed in letters beginning with A: i.e., a 1-inch difference represents an A cup, while 3 inches difference represents a C cup. Differences of greater than 4 inches are typically expressed in factors of D, such as DD or DDD.

Most studies done about breast size found that breast size has been getting bigger over the last few dacades. It is definitely related to the higher intake of animal foods which increase the level of hormones in the body.  The higher intake of animal foods  has been the reason for higher incidence of obesity as well as heart disease, cancer, strokes and many other diseases.

 In November 2005, Oprah Winfrey produced a show devoted to bras and bra sizes, during which she revealed research that eight out of ten women wear the wrong size bra.  Pendulous breasts can make it difficult for a woman to properly fit a bra. For best results, the breasts should be measured twice: once when standing upright, once bending over at the waist with the breasts hanging down. If the difference between these two measurements is more than 10 cm, choose the number halfway between them as a starting point for calculating the cup size.  The current popular system of determining bra size is inaccurate so often as to be useless. Add to this the many different styles of bras and the lack of standardization between brands, and one can see why finding a comfortable, well-fitting bra is more a matter of educated guesswork, trial, and error than of precise measurements. Bad bra-fit symptoms
If the straps dig into the woman's shoulder, leaving red marks or causing shoulder or neck pain, the bra band is not offering enough support.[43] If breast tissue overflows the bottom of the bra, under the armpit, or over the top edge of the bra cup, the cup size is too small.[43] Loose fabric in the bra cup indicates the cup size is too big.[44] If the underwires poke the breast under the armpit or if the bra's center panel does not lie flat against the woman's sternum,[45] the cup size is too small.[43] If the band rides up in woman's torso in the back, the band size is too big. If it digs into the flesh, causing the flesh to spill over the edges of the band, the band is too small. If a woman has to continually adjust her bra or experiences general discomfort, the bra is a poor fit and the woman should get a new fitting. If the band feels tight this may be due to the cups being too small, instead of going up in bandsize a woman should try going up in cupsize. Similarly a band might feel too loose if the cup is too big. To test whether a bra band is too tight or too loose the bra should be turned so that the cups are in the back and then be closed in front.

Measuring cup size without a bra

Women who have difficulty calculating a correct cup size may be able to find a correct fit using a method adopted by plastic surgeons. Using a flexible tape measure, position the tape at the outside of the chest, under the arm, where the breast tissue begins. Measure across the fullest part of the breast, usually across the nipple, to where the breast tissue stops at the breast bone. This measuring approach assumes that the woman's breasts are not so large or pendulous that they sag significantly, making measuring across the fullness of the breast impractical.[61]

Conversion of the measurement to cup size is as follows:[61]

Measuring cup size
Measurement Cup size
inch cm
7.0 17.8 A
7.5 19.1 A
8.0 20.3 B
8.5 21.6 B
9.0 22.9 C
9.5 24.1 C
10.0 25.4 D
10.5 26.7 D
11.0 27.9 DD
Contrary to popular belief, breasts weigh up to ~1 kg and not ~0.2 .. 0.3 kg. The popular documentary TV show I Didn't Know That uncovered this information in a broadcast program

Finding comfort in your own skin can be a challenge at any age and with any breast size. Some women simply take time to mold their personalities to fit the disposition of their bodies. However, other women truly feel alienated by their own anatomies and never really find that feeling of self satisfaction. These are the women who stand to benefit the most from drastic body image correction. If you can envision the ideal you, but just can’t achieve it through conservative means, then maybe it is time to consider a surgical solution.

There is nothing wrong with wanting to change your body, if you are attempting the alteration for positive and justifiable reasons. Before undergoing any cosmetic surgery, make sure to spend some time considering the internal motivations driving you towards the procedure. Having good motivation is one of the most important factors in determining final satisfaction from your operation. To learn additional information about non-surgical or operative interventions to change your breast placement or size, talk to us today.Having large heavy breasts can be a problem for many women. Traditional breast reduction with excision leads to large number of side effects and complications.  Breast contains a large amount of fat and the proportion of fat can increase as patients age.

Excess weight of the breast can cause back neck and shoulder pain, grooves in the shoulders from the bra straps, pain in the breasts, difficulty to exercise, embarassment, feeling of physical unattractiveness, problems with personal hygiene, disruption of sleep,  occasional symptoms of hand numbness from ulnar nerve entrapment.  bigger is not always better and this is specially true for the breast size. Finding the right size of clothing can be a big challenge for these patients.

Breast enlargement typically happens during puberty or soon thereafter. Sometimes it happens with the pregnancy and then the enlargement persists.

Tumescent local anesthesia is usualy used for breast reduction with liposuction and on the average a cup size reduction can be obtained with the liposuction.  With liposuction the patients are able to retain the natural original shape of the breast. There are no visible scars and a variable amount of breast lift happens after the wound healing in about two months.  


Usually after two months or three months removal of excess skin can be done for patients who have very loose breasts. (Breast ptosis).  This is also performed under local anesthesia and patients are able to return home right after surgery and usually are able to return to work next day.  If the laxity of breast is very severe the procedure is done in two stages. Below is the breast reduction performed with only a round cut around the areola. This provides a great lift if your breast has not go very lax. You are able to breast feed your next child and the scar will be minimal.

Sometimes the breasts can become quite lax and there can be unevenness of the breast size due to many reasons.  If the patient is looking to correct the breast laxity to a greater degree it can be accomplished with a new breast reduction technique.


Above breasts resulted in severe laxity and they were uneven in size as well to begin with. The breast reduction surgery brought the breasts to be reduced to the same level. Further correction of the size was done with the fat grafting to the left breast. Above picture on the right was taken at the time of stitch removal two weeks after the surgery. Patient was able to do her exercises more comfortably in the following weeks.

Above patient had very pendulous breast requiring removal of the excess skin skin. Nipple was simply moved to a new position and sutured. Brest grland was not excised.

In the picture above a similar surgery was performed to lift the breasts.

One of the issues with Sri Lankan skin is the possibility of keloids, hypertrophic scars as well as pigmented scars. Therefore in most cases we prefer to do only one circular scar around the areolar. (Dark skin around the nipple). With this unique surgery you can obtain a breast lift with minimum damage to breast gland. The skin will show some wrinkling (Pleats) at the scar for about a month or two and then it will improve slowly. Most of these patients are quite happy with the breast lift they with this technique since appearance of scar is almost invisible.