[Breast asymmetry of the teenager and the young adult. Stability of the result in time. About 144 patients]

Abstract

Introduction: Breast asymmetry is defined by a difference in breast shape and/or volume. The goal of this study was to assess the stability of the surgical results and to highlight predictive factors for deterioration in results.

Materials and methods: This retrospective and monocentric study included all patients presenting constitutional isolated asymmetry, Poland's syndrome, asymmetric tuberous breast or pectus excavatum treated between 1980 and 2015.

Results: The statistical analysis included 144 patients and contained two parts. The first analysis compared patients with or without breast implant. Results were significant only for symmetry of shape, with better outcomes without breast implant (P=0.0170). The second analysis compared the subgroups of patients with breast asymmetry, according to the etiology. Patients with tuberous breasts and constitutional isolated asymmetry have been compared. We found a significant difference only regarding the long-term results (P=0.0091). Patients with tuberous breasts had deteriorating in results over time. Patients with Poland's syndrome, compared to patients with constitutional isolated asymmetry, had significantly less good results for symmetry of volume, of shape, of areola, and for early results (P<0.025). Concerning patients with pectus excavatum, the early and long-term results and the stability were good for most patients.

Conclusion: Better results have been obtained with similar surgical procedures on both sides. Predictive factors for instability of results were the use of unilateral breast implant, weight variations, pregnancies and breast-feeding, the use of hormonal treatments, ageing and tuberous malformation.

Keywords: Asymétrie constitutionnelle; Autologous; Autologue; Breast implant; Constitutional asymmetry; Fat graft; Lipofilling; Long-term result; Poland; Prothèse; Résultat à long terme; Seins tubéreux; Tuberous breast.