Stuart. A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.
Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery (ABPS).
Breast asymmetry can include a unilateral large sagging breast on one side with a smaller tubular shape breast on the contralateral side. Other variations of breast asymmetry can include simply similar shape and size breasts without skin laxity or ptosis, but with different cup sizes. The most classic form, however, is a unilateral large sagging breast and a contralateral small tight tubular shape breast. This may be a congenital anomaly that has been notable since infancy with the child.
The specific implants used depends upon the amount of breast tissue and the appearance the patient desires to achieve. Both saline and silicone implants can be used.
Useful for women desiring less projection.
Useful for women with thick chest walls.
Useful for patients with thin chest walls.
Useful for patients who desire a larger implant.
|Easy To Conceal||No||Yes||Yes||Yes|
|Effects Breast Feeding||<5-8%||5-8%||<5%||<5%|
|Incision Point||Breast crease||Under areola||Armpit||Bellybutton|
In terms of techniques, in the typical breast asymmetry patient, one breast will show larger and saggy breast, the smaller one will be tubular, conical in shape and smaller and tighter. For example, the tighter breast should have a saline implant placed in the dual plane technique, for example, with release of the parasternal attachments of the pectoralis major muscle and release of the inframammary fold as well as rounding out of the lower pole of the breast. Once this has been placed, the contralateral smaller implant can be placed in the dual plane, then a formal mastopexy can be performed. Patient is placed in the sitting position and if further tailoring by breast reduction of the medial and lateral flap is necessary, this can be done meticulously and carefully in order to regain symmetry with the contralateral breast.
Breast reductions can be performed on the larger asymmetric breast if there is a significant amount of breast tissue which should be removed in order to regain symmetry and visual appearance when placing implants bilaterally. Normally, implants are placed in both breasts, even on the larger breast, in order to allow for similar upper pole fullness with the implant under the muscles. When performing the mastopexy or breast reduction, the patient must be aware of the scarring which can be unpredictable. Keloid hypertrophic scarring, widespread scarring hyper and hypopigmentation can occur and the patient must be aware of this. Patients under the age of 18 must require a parental guardian, sign all consents and review of all consents with the patient and should be in the room with the patient during all consultations and preoperative visits.
Removing skin along the areolar
Known to be an unpredictable incision, may cause additional scarring.
Allows tightening of the breast and repositioning of the nipple areolar complex.
Useful for patients with severe ptosis, this is known as a formal mastopexy.
Breast asymmetry procedures should be performed under general anesthesia with a Board Certified Anesthesiologist.
All anesthesia is performed by Board Certified anesthesiologist, Dr. Hoffman.
Laryngeal mask airways can be used in the majority of the patients. However, those who have a history of reflux or gastroesophageal disease are usually better candidates for endotracheal tube intubation. This should be discussed with your Board Certified Anesthesiologist.
Breast asymmetry cost will vary per patient.
This includes surgeon’s fee, operating room fees, implant cost and anesthesia fees.
|Preoperative||Patient is started on an intervenous antibiotic (Ancef, Cipro and Vancomycin).|
|Surgery||A primary augmentation takes between 45 - 60 minutes.|
|Recovery Room||At least one hour. This is a requirement of federal law in Medicare.|
|After Surgery||Patients are sent home with a Bias wrap and gauze in place. No heavy lifting or raising the arm above the shoulder for three weeks.|
|Postoperative Visit||All dressings are removed.
An upper pole compression band is placed which allows the implant to maintain an inferior position and softening of the muscle so that there will only be natural occurrence over the next four to six weeks.
Recommendation: The Linder Bra is a double clip zip mechanism, which allows easy placement with new gauze. It costs $49.95.
|Breasts are examined for bleeding, infection, and positioning of the implants|
|Days 8 - 14||Changing of the gauze will then occur twice a day for the next seven days.
Patients will do this at home
|The upper pole band may or may not be discarded, depending upon the placement of the implant at that time.
Sutures are removed
If there is any evidence of significant scabbing patients are asked to return in five days for final suture removal
|Days 14 - 21||Light activities can resume.
Incisions can get wet while showering.
Yes. There are absolutely no substitutes.
Absolute evenness of uniformity may not occur; however, more symmetry should occur and we do expect that the breast will be even in a bra, that the volume should look close enough to the eye that the patient does not feel asymmetric or hopeless.
Yes, the nipples will be surgically aligned by creating a breast asymmetry on the side where there is skin laxity and the nipple is below the fold.
We have operated on women as young as the age of 16 with the approval of the pediatrician due to severe disfigurement associated with physiological and psychological torment. Note: Recovery is a little different than primary augmentation, especially on the contralateral side where a reduction lift was performed. This can take up to 3-4 months for complete resolution of full edema and swelling. Sutures may stay in longer on this side than the primary augmentation contralateral side and this patient may require further scar treatments on this side, including Bio Corneum twice a day for up to one year.
California and Nevada
Brighton Surgery Center - It is a Medicare Licensed Surgery Center in Beverly Hills, California.