There are many patients that have asymmetry between the breasts as a result of some congenital malformation. Some are due to abnormal breast development, while others are due to chest wall deformities that can effect the breast size, shape, and projection. Below are a list of the most common congenital breast and chest wall deformities:
Pectus Excavatum - depressed sternum, often with small and asymmetric breasts.
Pectus Carinatum - prominent sternum, making the breasts appear smaller then they really are.
Anterior Thoracic Hypoplasia - unilateral depression of the chest wall, often times with a smaller breast and slightly higher nipple.
Poland's Syndrome - lack of the pectoralis major muscle on one side, with a resultant chest wall deformity and smaller breast.
Tuberous Breast Deformity - breasts that are constricted at the base, with the nipple/areola appearing large and the breast appearing to push through the areola.
Congenital Breast Hypoplasia - breasts that fail to develop, even after a women has fully matured and completed all pubertal changes.
There are various ways to correct each asymmetry problem. Sometimes it is by using different size and types of implants on each breast to balance and make them appear more symmetrical. Other times, custom made chest wall implants are designed to fill out depressions and balance the chest wall deformities. Some patients require the addition of their own tissue, in the form of a latissmus flap or TRAM flap to help fill out the asymmetries and balance the breasts. Each problem is unique and needs a detailed plan that is going to maximize the aesthetic result.