Relative Distribution of Common Breast and Chest Asymmetries in 2051 Primary Augmentation Mammoplasties in Nonptotic Subgroup of Patients

Background: Breast and chest asymmetries are extremely common, and primary augmentation mammoplasty can be challenging in these cases. However, there is a paucity of information on the relative distribution of these asymmetries and the implant sizes used in these patients. Methods: A retrospective chart review of all consecutive cases of primary augmentation mammoplasty performed by a single surgeon from May 1999 to May 2012 was conducted. Patients with chest and breast asymmetries were noted by clinical examination and observation. These patients were selected to review how many patients had similar or different-sized implants. Patients presenting with unilateral or bilateral ptosis and requiring mastopexy were excluded. Results: A total of 2051 patients underwent primary augmentation mammoplasty. Uneven chest wall or uneven ribs were noted in 274 patients (right more prominent 72, left more prominent 202). Of these, 169 patients had implants of the same size, and 37 patients had implants of different sizes. Similarly, 1008 patients presented with uneven breasts, and of these, 272 patients had different-sized implants. One patient needed revision surgery for implant size and breast volume readjustment. Conclusions: Chest and breast asymmetries are extremely common. Routine clinical examination is more than adequate to delineate such asymmetries. The majority of these patients have small differences, and not all patients with asymmetries require implants of different sizes.