Suhail, Dernas;
Faderani, Ryan;
Kalaskar, Deepak M;
Mosahebi, Afshin;
(2023)
Optimal Strategies for Addressing Developmental Breast Asymmetry and the Significance of Symmetrical Treatment: A Systematic Review.
Journal of Plastic, Reconstructive & Aesthetic Surgery
10.1016/j.bjps.2023.06.056.
(In press).
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Abstract
BACKGROUND: Approximately one quarter of women are affected by asymmetry as a result of abnormal breast development, which can lead to significant emotional distress. Despite this, there is currently no widely accepted approach for managing this prevalent condition. This systematic review aims to review the available literature on the management of developmental breast asymmetry. METHODS: A comprehensive search in MEDLINE, EMBASE and CENTRAL databases was conducted for primary clinical studies reporting on the management of developmental breast asymmetry from 1962 to November 2022. The primary outcome measures were long term aesthetic outcome and patient reported outcomes. RESULTS: 11 case series and 2 cohort studies were included, comprising a total of 1237 patients with a mean age of 26.5 years (range 14-65). Twelve studies (92%) addressed asymmetry through surgical means, using various augmentation and reduction procedures, while one study (8%) utilised external prosthesis. Meta-analysis of the data was not deemed to be possible due to heterogeneity of data, a narrative synthesis of the literature was provided. CONCLUSIONS: There is no consensus on how to manage developmental breast asymmetry. Furthermore, there is a lack of consistency in the classification of patients with developmental breast asymmetry and in the reporting of outcomes, highlighting the need for a consensus. Further research outlining long term aesthetic and patient reported outcomes is needed to understand which procedures provide optimal outcomes. Additionally, external breast prosthesis is a promising non-surgical alternative and further studies into its efficacy are needed.
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