PLANNING

During your consultation with Dr. Kolker, he will thoroughly discuss your goals and desires with you. No two individuals with breast asymmetry are alike, and every individual's goals regarding surgery are unique. After a detailed history and a thorough discussion of the factors in your breast asymmetry that concern you most, the doctor will examine you, making meticulous measurements that will both qualify and quantify the degree of asymmetry in both size and shape.

There are often numerous potential solutions, and the procedure, or combination of procedures, for the correction of breast asymmetry that suit you best will be reviewed in detail with you. When one breast is larger and the other smaller, the larger breast may be reduced (breast reduction or breast lift) to match the smaller breast, the smaller breast may be "sculpted" to improve its shape and made larger with an implant to match the bigger breast (breast augmentation or augmentation mammoplasty), or both may be made larger with implants by placing an appropriately larger implant on the smaller side, and smaller implant on the larger side to achieve balance and symmetry.

How do I determine which breast asymmetry procedure is best for me - breast enlargement, breast lift, breast reshaping, or breast reduction? I really like one of my breasts; should both breasts be treated or just one? If a breast augmentation is chosen, which breast implants should I select, silicone or saline? Should they be placed above or below the muscle? As your particular needs and desires are unique, Dr. Kolker will discuss all of the alternatives, and help you to make sense of all of the variables that will enable you to tailor the procedure that suits you best.

PROCEDURE

After in-depth discussion and careful consideration, together you and Dr. Kolker will select the ideal combination of techniques for the correction of your breast asymmetry. In cases where both breasts are small and changes in breast size only are selected (breast augmentation), the incisions may be placed in the crease beneath each breast (inframammary breast augmentation), in the junction between the dark and light skin beneath the areola (periareolar breast augmentation), or in the armpit (transaxillary endoscopic breast augmentation, using a special camera called an "endoscope" to visualize the breast), placing implants of different volumes in order to restore balance in the size of the breasts. The breast implants may be placed below the chest (pectoralis) muscle (subpectoral breast augmentation, or submuscular breast augmentation), beneath the breast gland or partially beneath the gland and muscle (subglandular breast augmentation or dual-plane breast augmentation). Most often, Dr. Kolker favors placement beneath the muscle, however in certain cases of droop or breast constriction, placement beneath the breast gland may be advised. Silicone implants or saline implants can be chosen, and depending upon your physical requirements as well as your desires, Dr. Kolker will advise you on the implant that suits you best. In many cases of breast asymmetry, more than just "breast augmentation" is required. When breast lift, breast reduction, nipple-position adjustment, areolar size adjustment, or breast reshaping are indicated, an incision is placed around the circumference of the areola. Certain circumstances where a more substantial breast reduction or breast lift is required may necessitate the addition of a vertical incision (short scar breast lift or short scar breast reduction), or a vertical incision with an incision in the crease beneath the breast. The procedures to correct breast asymmetry is performed safely, comfortably, and conveniently in our office-based surgical unit, accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). Anesthesia is administered by a board-certified anesthesiologist. As many cases of breast asymmetry require a combination of techniques and fastidious sculpting, the duration of breast asymmetry correction often ranges from two to four hours, although Dr. Kolker will spend as much time as is necessary to achieve the most balanced and beautiful results.

RECOVERY

Following the correction of breast asymmetry, you are cared for in our recovery room by our licensed registered nurse, and when you are fully awake and comfortable, you will go home on the same day with a friend or family member. Dr. Kolker suggests taking seven days for recovery when feasible, although it is indeed possible to return to work or school as early as four or five days after your breast asymmetry correction procedure (provided there is no heavy lifting involved). With few exceptions, all sutures placed are dissolvable and no suture removal in necessary. When a breast lift or breast reshaping is a part of the procedure, small drain tubes will often be used that are removed in three to five days following surgery. Your breasts will appear full and firm immediately after breast asymmetry surgery, and swelling and bruising may be present for up to three weeks. A special supportive bra is worn for three to five days, which is then replaced by a sport bra. Normal bras and bikini tops can be worn after about three weeks. Light aerobic activity (elliptical or Precor, stationary bicycle, light treadmill) may be resumed as early as seven days following the correction of breast asymmetry, and more strenuous activity is begun at three weeks (excluding chest exercise, which is resumed at six weeks). The breasts reach their final shape and feel approximately three months after correction of breast asymmetry. Your relationship with Dr. Kolker does not end after your surgery; he will see you often through the first weeks and months following your procedure, and will advise you on all matters of breast health including exercise, activity, breast self examination, and the need for future mammography as you require. Dr. Kolker will be available to you at any time during your recovery period.

RELATED PROCEDURES

The correction of breast asymmetry is most often performed as an isolated procedure. For those individuals who desire additional plastic surgery enhancements, breast asymmetry correction may be combined with inverted nipple correction, breast lift (augmentation mastopexy), liposuction, tummy tuck (abdominoplasty), and facial rejuvenation procedures.

If you would like to learn more about correction of breast asymmetry in New York, we invite you to meet with Dr. Kolker for a private consultation at our office, located at Park Avenue and 70th Street in New York City, by calling 212-744-6500, or by scheduling an appointment online.