Outcomes of surgical correction for congenital breast asymmetry

Objective. To compare the effectiveness of symmetrical mastopexy with different-sized Mentor and Motiva implants versus asymmetric surgical techniques in correction of congenital breast asymmetry. Material and methods. A prospective cohort study included 28 patients with congenital breast asymmetry who underwent surgery in 2021—2025. The main group (n=20) underwent symmetrical mastopexy (identical procedure on both breasts) with different-sized implants. The control group (n=8) underwent asymmetric procedures (different types of mastopexy and/or incisions) also with different-sized implants. Morphometric parameters (sternal notch-to-nipple distance, nipple-to-inframammary fold distance, midline-to-nipple distance, areola diameter, breast footprint width), patient satisfaction (BREAST-Q), complication and redo surgery rates were assessed. Nonparametric methods (Mann—Whitney U test, Wilcoxon signed-rank test) were used. Data were presented as median and interquartile range Me [Q1; Q3]. Results. In the main group, postoperative absolute differences between sides were 0—0.1 cm for all parameters. The control group retained residual differences in nipple-to-inframammary fold distance (0.3 [0.1; 0.7] cm) and midline-to-nipple distance (0.2 [0.1; 0.4] cm) (p<0.05). The median BREAST-Q score at 6 months was 99.0 [98.0; 100] and 89.0 [85.0; 93.0], respectively (p<0.01). Redo surgeries were performed in 5 (25.0%) and 3 (37.5%) patients, respectively. Areola corrections dominated in the main group (4 out of 5). In the control group, implant exchange and areola corrections were carried out in 1 and 2 cases, respectively. No capsular contracture or infectious complications occurred. Conclusion. Symmetrical mastopexy with different-sized implants provides more accurate restoration of symmetry compared to asymmetric procedures with comparable satisfaction and acceptable redo surgery rate.