Surgery to improve breast symmetry

After surgery to one or both breasts, you may find your breasts are different sizes. This can happen due to lumpectomy (‘breast-conserving surgery’), mastectomy, breast reconstruction or radiotherapy.

For some people the difference may be small and for others it might be more noticeable.

There are options to improve the appearance of your breasts. It is your choice whether or not to have an additional procedure.

Reshaping during breast surgery

If you are having a lumpectomy (breast conserving surgery), sometimes the surgeon can reshape your breast or breasts during the surgery. This is called oncoplastic breast surgery and it aims to improve the look of the breast.

Oncoplastic breast surgery is not possible or suitable for everyone. Ask your breast surgeon before your surgery if it is an option for you. There are several types of oncoplastic surgery.

1. Therapeutic mammoplasty

Therapeutic mammoplasty reshapes the breast to fill the area where the cancer was removed.

Often this technique makes the affected breast smaller. At the same time, you may be able to have surgery to make your breasts even ('symmetrical').

Usually this involves a breast reduction: your other, unaffected ('contralateral') breast is made smaller to match the affected breast.

2. Mastopexy

This is a breast lift. Mastopexy is often done at the same time as other breast surgery. 

3. Partial breast reconstruction

The surgeon replaces the breast tissue using spare skin (a 'flap') and fat from:

• the side of your chest
• your back
• around your breast.

Your surgeon will explain this technique to you. They may also talk about other options for a tissue flap reconstruction.

You may still need radiotherapy to the remaining breast tissue to reduce the risk of the cancer coming back.

Some people decide to have separate breast reconstruction surgery later.

Symmetry surgery after breast surgery

Symmetry surgery is generally done after other breast surgery. This allows any temporary swelling to reduce in your affected breast.

The aim is to make the other breast - the unaffected or 'contralateral' breast - look similar to the affected breast.

Symmetry surgery to the other breast may involve:

• reducing its size
• increasing its size (for example, to match a reconstructed breast)
• lifting the breast.

Talk to your surgeon if you think you want to consider symmetry surgery.

Fat graft procedure

In a fat graft procedure, fat is taken from part of the body such as the thigh and injected into the breast.

This is also called ‘fat transfer’ or ‘lipofilling’.

Fat grafting can be used:

• after breast conserving surgery, to improve the appearance of the breast
• after breast reconstruction (tissue or implant) to adjust the size of the breast
• after breast reconstruction (implant) to the breast look smoother if there is rippling
• to create a small breast mound for people who have small breasts. You generally need multiple transfers over 1 to 2 years. Often it takes 1 to 3 sessions to achieve the desired look and shape. Sessions are often spaced 3 to 6 months apart to allow for healing in between.

After a fat graft you may have some swelling, bruising and pain in the area where the fat was removed. This will settle, but the healing time varies from person to person. Speak to your doctor if you have any questions or concerns.