Correction of facial asymmetry can be accomplished by many different techniques.  I would recommend that you attempt a "non-permanent" procedure first to see how you like the results.  I simpler procedure would be a dermal filler such are Radiesse or other fillers which can be used to sculpt the deficient side.  If you are not satisfied with the results the dermal filler will eventually absorb.  If you are satisfied with the results then you can plan on either a facial implant on the deficient side, bony recontouring of the larger side, or facial fat grafting to the smaller side.

Facial Implants

Upon reviewing the height weight and bra size given, my first response is to your body size and image.  For a woman who is reported to be 5 feet 7 inches in height, the Metropolitan height weight table suggests weight would be in the range of 121-147 pounds, depending on your body frame size.  Your reported weight is 223 pounds which conservatively means you should first reduce your weight by approximately 76 pounds.  An overall weight reduction program would be an excellent goal to improve your overall health and fitness.  Weight loss will also reduce the weight on your musculoskeletal system and decrease the stress on your spinal column and shoulders.

The second issue is your breast size.  Your breasts are composed of a certain percentage of fatty tissue, which increases with age (fatty tissue to glandular tissue ratio).  At 19 years of age, most of your breast tissue would be glandular.  However at a weight of 223 pounds there is most likely an increased percentage of fatty tissue present.  My suggestions would be to first incorporate a plan of healthy eating, exercise and overall weight reduction.  As you approach your more ideal weight and build stamina and improved fitness you should be evaluated for a possible therapeutic breast reduction.  I would work on both of these together as a holistic approach to your issues of large breast and shoulder grooves.

Breast Reduction

This is one of the most frequently asked questions of my patients concerning breast implants. I do not have a great deal of military personnel in my practice, but I do have a many weight-lifting females.

My recommendations are as follows. If the breast implants are placed above the muscle then I tell my patients that they can resume all exercise, including weight-lifting and sports, in 6-8 weeks after the surgery. This is assuming that there are no complications postoperatively.

If the breast implants were placed under the muscle, which I do in about 95% of the cases, then my instructions are as follows: no exercise and no weight-lifting for the first two weeks. You can start walking either outside or on the treadmill after two weeks. You can resume lower body training and sit-ups after one month. You can start jogging and light upper body weights after two months and resume all unrestricted weight-lifting, exercise and sports after three months. Some other physicians may consider this postoperative plan conservative and cautious; however, I have seen postoperative bleeding even after 3-4 weeks in patients who start exercising too early.

Breast Augmentation

My recommendations are to treat the individual components of your neurological disease. If the eyelids are your main concern, than either an eyelid lift or lid tightening procedure can be performed. In some cases a "gold weight" may need to be inserted in the upper eyelid to provide additional weight to the eyelid if closure is a problem.

If the "jowls" or skin of the facial region is your concern, than once again a tightening or lifting of the cheeks, jowls or mid face may be performed. If areas in which the skin or musculature have become thinned or atrophic, fat grafts or dermal fillers may be helpful to provide additional fullness and enhance the contour of the facial region. In all cases, a complete evaluation and examination needs to be performed by a board certified plastic surgeon prior to establishing a treatment plan for your options.

Eyelid Surgery

Thank you for your email concerning revision breast reduction surgery. The use of liposuction as a technique in breast reduction surgery is well documented and accepted. The skin of the breasts after the liposuction needs to re-contour about the remaining glandular tissue. Depending on the patient’s age, weight, medical history and smoking history, the skin may not contract and tighten about the breast gland, as one might wish.

In those cases, a formal breast lift (mastopexy) may need to be performed in order to tighten and re-shape the breast. At the same time a revision of the breast reduction can be performed if one wants additional tissue to be removed; the size and shape of the nipple and areolar appearance can also be altered if desired.

Breast Reduction