Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_591_Библиотеки_им_академика_М_И_Перельмана

polythelia, and polymastia. An acquired asymmetry may be the result of trauma (e.g., a burn or a human/animal bite) or iatrogenesis (e.g., after mastectomy for resection after breast cancer, secondary to augmentation mastoplasty, or secondary to reduction mastoplasty).

In addition, the appearance of asymmetric breasts may develop physical altera­tions on the vertebral column of the spine and torso (Fig.17.1), with severe reper­cussions on the respiratory system caused by an imbalance in the chest, according to Pitanguy (1967). Therefore, its correction is a matter of physical reparation to achieve harmony in the body and avoid negative repercussions on wellbeing of the patient (Fig.17.2). The treatment is essentially a surgical approach that frequently consists of mammary reduction in one side and a silastic inclusion in the other, which makes achieving a balance in the chest even more difcult (Fig. 17.3) (Pitanguy 1959). Until recently, when both breasts presented noticeable hypertro­phies with severe asymmetry in adulthood, reduction mastoplasty can be performed for the resection of the excess breast tissue (Figs.17.4 and 17.5). Even at such an age, the presence of adipose tissue may cause a similar asymmetry that demands careful management to achieve balance after the operation (Avelar 2000a). On the other hand, asymmetric breasts may present with bilateral hypomastia, which requires augmentation mastoplasty on both sides by using different sizes of breast implants.