How Cosmetic Procedures Can Address Body Asymmetries

When it comes to our bodies, you’ll be hard pressed to find anyone who is perfectly symmetrical. These asymmetries can be due to genetics, skeletal conditions, or overuse of muscles on one side compared to the other, and, for some patients, the degree of difference is significant enough for them to seek out a way to even things out. Read on to better understand how cosmetic procedures can address asymmetries from both provider and patient perspectives.

What Causes Body Asymmetries

Body asymmetries are the rule, not the exception. “I have yet to meet a patient who is completely symmetric — asymmetry is a fact of life,” says Gregory Buford, MD, a board certified plastic and reconstructive surgeon in Lone Tree, CO. “Complete symmetry actually is often less attractive than a little asymmetry, but, like anything in life, it's all about balance. A little difference can look nice while severe asymmetry does not.”

While asymmetry can exist anywhere on the body, it is more common in some areas than others. “The majority of women have some degree of breast asymmetry,” says Umbareen Mahmood, MD, a board certified plastic and reconstructive surgeon in New York City. “Many people also have asymmetry in their hips and shoulders, buttocks, legs, and hands.”

People with anatomical or structural asymmetries may experience differences in the appearance of one side of their body compared to the other because of genetics or conditions such as scoliosis. Functional asymmetries can occur for a variety of reasons, though they generally involve muscle imbalances either from overuse or because of the body having to over-compensate (think: due to an injury).

How to Treat Body Asymmetries

Understanding balance, proportion, and, yes, symmetry is key to any cosmetic surgery or procedure. “One of the most important components of evaluating any patient is recognizing asymmetries and trying to minimize them,” Dr. Mahmood says. As she explains, “asymmetry itself is not bad — it is inherent in every human being and is natural.” With that said, “it is important to recognize the variability, so that treatments can try to decrease them versus exacerbate them,” she notes.

One of the most obvious examples? The aforementioned breasts. “If a patient with breast or nipple asymmetry gets a breast augmentation with the same size implant, the asymmetry will be highlighted,” Dr. Mahmood cautions. With that in mind, it’s important to visit a board certified provider who will be able to evaluate the entire body and how these asymmetries relate to one another. To give you a better sense of what that entails, we’ve broken down a few of the most common treatment areas below:

For Breasts

“I would say that the area where I see the most asymmetry is in the breasts,” Dr. Buford shares. “This difference can range from mild to severe and the patient may not even be aware of the difference until it is pointed out.” The goal, however, is not necessarily to create a ‘perfect’ result. “The art of plastic surgery and the opportunity is to try and even out this difference, although I emphasize to each patient that we will never achieve mirror image results,” he notes.

“I always tell patients, ‘breasts are sisters, not twins,’” Dr. Mahmood quips. Even so, your sisters may be a little too different for your taste, in which case there are an array of surgical procedures — from breast augmentation and breast reduction to breast lifts — that can be performed. In fact, the treatment protocol is anything but one-size-fits-all. “For the breast, it depends on what the asymmetry is,” she says.

If your breasts are both “overly large or ptotic” (read: sagging), then “the treatment is a breast reduction and/or mastopexy” (i.e. breast lift) “with more tissue removed from the larger side,” Dr. Mahmood explains. For patients who have volume asymmetries and prefer the size of the larger breast, “the treatment can be a breast augmentation with implants, fat transfer, or combination of both,” she shares. From there, the surgery and recovery process is similar to that of any breast procedure.

Additionally, it’s important to consider the chest as a whole. “In this area, it's not only about asymmetry of the breasts but also about asymmetry of the chest wall itself,” Dr. Buford explains. “It is not uncommon for a patient to have either pectus excavatum (concave chest wall) or pectus carinatum (convex chest wall) or both. Add scoliosis to this and the difference in the projection of the breasts becomes even more pronounced.”

All of this should be taken into account when devising a treatment plan. “For the breasts, the sky's the limit,” Dr. Buford says. “I often use different sized implants to even out volume differences and can go as far as fat grafting to one or both sides to also aid in achieving greater symmetry.”

For the Waist, Hips, & Buttocks

Addressing waist and hip asymmetries is generally similar, in theory, to the breasts: reduce one side and/or make the other side larger. “Asymmetry in the hips and shoulders is often reflected in an uneven distribution of subcutaneous fat, with one flank having more fullness or one side of the posterior bra roll area being more pronounced,” Dr. Mahmood explains. In such cases, “liposuction of the subcutaneous fat in the area that has more fullness can help minimize the skeletal asymmetries,” she notes.

If your backside is a cause of concern, volume can be restored via fat grafting or implants. “Asymmetry in the buttock can be addressed with gluteal augmentation with fat transfer and/or gluteal implant,” Dr. Mahmood says. Fat grafting procedures involve removing fat from a donor site (think: the low abs or flanks), purifying the tissue, and injecting it into the area you wish to enhance. The procedure is not an option for people with low amounts of body fat because there is not enough tissue to remove and transfer. The body metabolizes around 30 to 40 percent of the grafted tissue within the first year of surgery, but there is no risk of rejection. If this sounds like the makings of a Brazilian butt lift (BBL), it’s because the fat transfer techniques are similar.

Gluteal implants, on the other hand, are usually made of silicone (a firmer version than you’d find in breast implants). They are custom-fabricated to fit your body’s exact contours — ideal for patients looking to correct asymmetries. It should be noted that butt enhancement procedures do come with a rather significant recovery period that involves not applying pressure to the area for the first couple of weeks, so it is important to keep that in mind when considering your treatment options.

Patient Perspective

Lara* grew up with scoliosis, which led to asymmetry of her shoulders, chest, waist, and hips. As she grew older, she decided she wanted to pursue cosmetic procedures to address some of them. Here, she shares her experience.

A Quick Note on Facial Asymmetries…

Completely symmetrical faces are as rare as perfectly symmetrical bodies, so having a certain degree of difference on each side of your face is normal. Generally speaking, facial asymmetries can be broken down into three main categories:

• Structural Asymmetries: These originate with the structure of the bones that form your facial features (think: a crooked nose).
• Functional Asymmetries: These tend to become visible when you use your facial muscles and can have several different origins, including overuse, nerve damage, and scar tissue.
• Asymmetrical Aging: Changes in the rate of aging between one side of the face and the other can be due to a range of factors, including the way you sleep (here’s looking at you, side sleepers), uneven sun exposure from driving, and more.

As with body asymmetries, if you have concerns about the proportion of your facial features, it is best to consult with a board certified dermatologist or plastic surgeon. There are an array of surgical and non-surgical treatment options that will be able to address the overall balance and harmony of the face.

*Patient’s name has been changed