As plastic surgeons, we analyze symmetry of the human form nearly every time we operate. Usually, this is accomplished with two-dimensional measurements and visual perception. Correcting a significant breast asymmetry, either by decreasing or increasing breast volume as well as modification of the skin envelope, challenges the artistic skills and spatial perspectives of the surgeon. Most rely on freehand intra operative sculpting, which even in the best of hands is imprecise.

Our purpose was to develop a versatile system of simple measurement techniques that can accurately predict the pattern of skin envelope alteration, nipple repositioning and/or volume adjustment required to correct asymmetric breasts. A “topographical” tape template of the desired breast shape is constructed for preplanning of the skin envelope and water is used to measure volume difference. This system was applied to five patients (four with congenital asymmetry and one with posttraumatic asymmetry). Postoperative results demonstrate excellent symmetry can be achieved using this system. These techniques apply to both unilateral surgery to match a normal opposite side as well as bilateral procedures that may require any variation of reduction, lift and/or volume change.