title: Correction of small volume breast asymmetry using deep parenchymal resection and identical silicone implants: an early experience.
abstract: BACKGROUND
  Virtually all patients presenting for augmentation mammaplasty will exhibit some degree of asymmetry. The use of asymmetric implants to address small- volume breast asymmetry introduces uncontrolled variables into the longevity of postoperative results.
  
  
  OBJECTIVE
  We described a novel method of addressing small-volume asymmetry using deep parenchymal resection (DPR) to achieve symmetry prior to insertion of identical implants. We also compared our results with this technique to a cohort of standard augmentation mammaplasty patients.
  
  
  METHODS
  All patients underwent 3-dimensional (3D) imaging during consultation. In patients with small-volume breast asymmetry, a uniform disk of deep parenchymal tissue was resected from the base of the larger breast cone through an inframammary incision. A standard submuscular augmentation was then completed. Five patients (DPR group) with appreciable small-volume asymmetry underwent DPR in the larger breast prior to insertion of identical implants. Fifty-six consecutive patients with no appreciable volume asymmetry (standard group) underwent standard submuscular breast augmentation.
  
  
  RESULTS
  Using 3D imaging preoperatively, DPR-group patients had an estimated breast volume asymmetry of 86 ± 58 g and had 55 ± 27 g excised from the larger breast intraoperatively, allowing for insertion of identical implants in each patient. Complications in the standard group included 1 case of rippling and 2 cases of malposition. One case of malposition was noted in the DPR group. No other complications were recorded in either group over 6 months.
  
  
  CONCLUSIONS
  Our novel method of addressing small-volume breast asymmetry allows for the use of identical implants and presents no increase in early complications.
authors.affiliation: Dr Somogyi was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Toronto, Canada. Dr Stavrou was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Cyprus, Greece. Dr Southwick is a plastic surgeon in private practice in Melbourne, Australia.
authors.forename: Ron Barry
authors.initials: RB
authors.lastname: Somogyi
authors.affiliation: Dr Somogyi was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Toronto, Canada. Dr Stavrou was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Cyprus, Greece. Dr Southwick is a plastic surgeon in private practice in Melbourne, Australia.
authors.forename: Demetris
authors.initials: D
authors.lastname: Stavrou
authors.affiliation: Dr Somogyi was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Toronto, Canada. Dr Stavrou was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Cyprus, Greece. Dr Southwick is a plastic surgeon in private practice in Melbourne, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Southwick
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology / Q000601:surgery; D019928:Breast Implantation / Q000379:methods*; D018427:Breast Implants; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D016462:Mammaplasty / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D020034:Silicone Gels; D055815:Young Adult
chemical_list: D020034:Silicone Gels