Surgical Management of Unilateral Breast Hypoplasia: A Case Report and Literature Review

Introduction: Breast asymmetry, particularly unilateral hypoplasia, poses significant aesthetic and psychological challenges. The surgical options are numerous and such cases require careful consideration and planning. This case report is of a 24-year-old female with severe right breast hypoplasia with pseudoptotic left breast and the surgical approach taken to improve symmetry. Materials and Methods: The patient underwent a combined approach of right breast augmentation and contralateral mastopexy reduction. Saline implant was chosen with placement via dual-plane pocket, filled to 300 cc. A superior pedicle reduction mastopexy was performed on the contralateral breast. The surgical strategy emphasized symmetry restoration while respecting patient preferences of avoiding left-sided implant. Results: Both intraoperative and postoperative results were satisfactory with improved breast symmetry. There were no postoperative complications. Discussion: Unilateral breast hypoplasia presents a challenge for surgeons. Every surgical decision needs meticulous planning while considering the patient’s preferences. A combined approach of right breast augmentation with concurrent left breast reduction mastopexy was performed, which is advocated for asymmetry correction. Saline implant was utilized as it allows for intraoperative volume adjustment and safety profile. A dual-plane implant pocket achieves the patient’s aesthetic goals while minimizing the disadvantages of a saline implant. In the pseudoptotic breast, a superior pedicle was chosen for the reduction mastopexy. It is a proven technique that preserves the nipple-areolar complex (NAC) with robust blood supply and is predictable in resultant shape and size. Surgical planning aside, incorporating a patient’s preferences can be psychologically therapeutic and leads to patient satisfaction. Conclusion: This case underscores the importance of tailored techniques in achieving optimal outcomes, supported by current literature.