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Breast Asymmetry

What is Botox?

Botox, or botulinum toxin, is an injectable treatment that is primarily targeted to treat wrinkles, fine lines and creases on the face. It can also be used as a non-permanent facial contouring treatment to slim down your profile. Botox is more widely known as an effective anti-aging product for improving the appearance of your skin. Botox is able to treat signs of advanced aging as it promotes collagen production and skin elasticity. In Singapore, Botox is used to temporarily give patients a younger and tighter look.

What is Breast Asymmetry?

Breast Asymmetry is a common condition where one breast is of a different size, volume, position or form from the other, giving you uneven breasts. This condition does not necessarily point to a bigger health issue but can become worrying if it points to cancer.

What causes it?

There are a number of factors that can explain why a woman’s two breasts are different in size or volume.

Normal growth variations

For one, most of our body parts, such as our legs and eyes, are not fully symmetrical. Hence, your uneven breasts may be attributed to normal growth variations. It is also during your developmental years that you may develop scoliosis, or curvature of the spine, where it causes one side of the rib cage to widen and, in turn, creates uneven breasts.

Hormonal changes

The hormonal changes that take place during puberty can cause one breast to grow before the other, even if they stop growing at the same time. If your breasts are uneven at the end of puberty, they are likely to remain uneven.


You may have already noticed that your breasts feel fuller and more sensitive during your menstrual cycle. This, too, is normal as you naturally retain water and additional blood flow that causes your breast tissue to expand. Once your menstrual cycle is over, your breasts would revert to their usual size.

Going beyond natural reasons, uneven breasts may also point to underlying medical conditions.

Juvenile or virginal hypertrophy of the breast

This is a rare condition where one breast grows significantly bigger than the other. It is often treated with surgery.

Deformities in the chest wall

These deformities affect the structure of your chest and, in turn, your breast size, shape, and projection. For example, the deformities can cause depression in the breast bone and or push the breast bone outwards.


The most concerning cause would be cancer. Uneven breasts could be due to the presence of a fibrous breast lump or a cyst. While they are mostly non-cancerous tumours, lumps can be cancerous. Hence, any sudden or recent changes in your breast size should be evaluated.

How do I know I have uneven breasts?

Did you know? Women whose breasts differ in size by over 20% may be at higher risk of developing breast cancer.

Besides regular mammograms, it is also good practice to keep a lookout for changes in your breasts. Some changes you ought to look out for include:

  • A change in the size or shape of your breast
  • A lump in or around your breast or under your arm
  • Changes in your nipple including discharge
  • Red, itchy, or scaly skin around your breast
  • Dimpled or puckered skin

Are uneven breasts painful?

Asymmetrical breasts do not cause any physical pain or discomfort but you may feel uncomfortable or unsatisfied with the appearance of your uneven breasts. However, if breast asymmetry is a symptom of breast cancer, you may experience pain in the breast or nipple.

Who is at risk of breast asymmetry?

Breast cancer is the most common cancer among women in Singapore. Each year, over 2,000 women are diagnosed with breast cancer and over 400 die from the disease.

Some women have a higher risk of developing breast cancer than others. This hinges on a few factors including:


The risk of breast cancer increases with age. Most women are diagnosed in their 40s.


Although breast cancer can affect men, the risk is much lower compared to women. However, when breast cancer is diagnosed in men, it is often at a much advanced stage because of the small size of the male breast.

Genetic inheritance

Certain genes, such as the BRCA1 and BRCA2, have been associated with breast cancer. Women who inherit an abnormal form of either of these genes are twice the risk compared to women without these genes.

Previous history

Women who have a history of breast cancer are at risk of the cancer recurring or developing in the other breast.

Reproductive history

Women who do not have children or had their first child after the age of 35 have an increased risk of breast cancer. Those who experience their first menstruation before the age of 11 and/or have their last menstruation after the age of 55 are similarly at higher risk.


Weight gain in post-menopausal women has been associated with breast cancer. Conversely, regular physical exercise and a balanced diet are known to reduce the risk of breast cancer. A balanced diet, particularly, should also include limited consumption of saturated animal fats and a good amount of fruits and vegetables. Together, these help to maintain a healthy weight.

Intake of hormones

Post-menopausal women who are on long-term Hormone Replacement Therapy (HRT) have a 30% increased risk of breast cancer. This risk is completely eliminated after three to five years of ceasing HRT. Separately, young girls between the ages of 10 to 15 who consume oral contraceptive pills are also at increased risk of breast cancer.

When should I see a doctor for uneven breasts?

If you develop sudden unevenness or notice unexpected changes in your breasts, you should consult a doctor for a clearer diagnosis.

You will minimally undergo a mammogram to check both breasts. If you have had past mammograms, your results will be compared to previous results for changes in shape or density. If this is your first mammogram and results indicate asymmetry, additional tests will be ordered to determine the cause of the changes.

An additional test could be an ultrasound test to diagnose abnormal findings from your mammogram results. An ultrasound will be able to produce clearer, more defined pictures of the breasts’ internal structure, which can help to determine if any mass in the breasts is potentially malignant or benign.

If your ultrasound results come back abnormal, or if your doctor suspects the abnormality is cancerous, a biopsy test of a sample of your breast tissue will be ordered. A biopsy will confirm the presence of cancer.

Where the biopsy results are negative, you will be advised to regularly monitor your breasts for any changes. Where the biopsy results are positive, which confirms cancer, your doctor will discuss treatment options with you.

Besides an ultrasound, you may undergo an MRI. An MRI can be carried out after a biopsy has confirmed cancer, or in combination with a mammogram. In fact, an MRI is particularly helpful for women with high risk of breast cancer.

How can I correct uneven breasts?

There are a few ways to improve the cosmetic appearance of uneven breasts. This, of course, is only applicable if the cause of your uneven breasts is due to non-medical reasons.

Breast Reduction

Breast reduction surgery is performed to reduce the size of large breasts for a more youthful shape. People with large breasts often suffer from neck, back, or shoulder pain. If you have uneven breasts, breast reduction surgery can reduce the size of your larger breast to even out the shape and size of your breasts. It would also ameliorate any pain associated with large breasts.

Breast Augmentation

On the flipside, breast augmentation is performed to give your breasts volume. This procedure involves surgically inserting an implant behind each breast to enhance its volume and shape, achieving breast symmetry.

If the cause of your breast asymmetry is due to an underlying medical condition, that condition needs to be addressed first. For example, if your breast asymmetry is a result of breast cancer, then you will need to undergo cancer treatment first before considering a procedure to improve the shape of your breasts.

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