As a family physician, I have known Narayan, Sugandhi, and their daughter Aditi for nearly 20 years. Narayan and Sugandhi both teach at a local engineering college. Today, they came to see me with Aditi, who is also studying engineering. Aditi had expressed concerns to her mother about having one breast noticeably larger than the other. Sugandhi took Aditi to see a gynecologist, who said breast asymmetry is normal but didn’t have time to fully address their questions and concerns. Feeling dismissed, they made an early appointment with me so we could discuss the issue in more depth. I could see that Aditi had developed an inferiority complex around her breast size difference.
(To protect their privacy, I have changed their names in this blog post to Narayan, Sugandhi, and Aditi. But the rest of the story and medical information remain the same.)
The Consultation Begins
Narayan: Doctor, thank you for seeing us on short notice. Aditi has been very worried and self-conscious about her breast size recently.
Me: Of course, I’m always happy to help. Aditi, can you tell me more about what’s bothering you?
Aditi: Well, I noticed that my left breast is significantly bigger than my right one. It’s really obvious, especially in swimsuits and certain tops. I feel so abnormal and unattractive. The gynecologist said it’s not a big deal, but I can’t stop fixating on it.
Me: I understand your concern, Aditi. Let me start by saying that having asymmetrical breasts is very common and completely normal. Research has found that over half of all women have visibly different-sized breasts.
Sugandhi: Really? I had no idea it was that prevalent. The gynecologist mentioned it was normal but didn’t elaborate.
Me: Absolutely. A study published in the Annals of Plastic Surgery found that breast asymmetry of up to 20% in volume is present in over 50% of women. So you’re definitely not alone, Aditi.
Aditi: Wow, I guess I thought I was some kind of freak or that something was really wrong with me. But why does it happen?
Reasons for Breast Asymmetry
Me: There are several reasons why breasts can develop asymmetrically. In many cases, it’s simply the natural way a girl’s breasts grow during puberty. Even though breasts usually develop at the same time, it’s common for one to grow more quickly or larger than the other.
Narayan: So it’s often just a matter of one breast getting a head start in the development process?
Me: Exactly. And in most cases, the other breast will catch up over time and even out the difference. However, some degree of asymmetry often remains into adulthood.
Other causes of asymmetry can include hormonal changes or imbalances, medical conditions like scoliosis or injuries, breastfeeding, and in rare cases tumors. Aditi, based on your age and health history, your asymmetry is most likely a normal developmental variation.
Sugandhi: What about all these rumors that certain foods, oils, creams, or massages can change your breast size and shape? Do those play any role?
Me: No, those are myths not supported by scientific evidence. Breast size is determined primarily by genetics and body weight. Hormones like estrogen also influence breast growth and cyclical changes. But topical products and massages don’t alter breast size. Those remedies are frequently promoted to play on women’s insecurities but they aren’t proven to work.
Aditi: I read online about certain exercises that supposedly help even out asymmetrical breasts. Is there any truth to that?
Me: Building up the pectoral muscles behind the breasts with chest exercises can make the breasts appear slightly lifted and firmer. But it won’t significantly change their size or asymmetry. Breasts are comprised of fat and glandular tissue, not muscle, so you can’t spot-train them like other body parts.
Stages of Breast Development
Aditi: How can I know if my breast development is normal for my age? What are the typical stages it goes through?
Me: Great question. Breast development happens in five stages called the Tanner stages. Stage 1 is the flat, pre-pubescent chest. Stage 2 is when the breast buds first start developing, typically between ages 8-13. The areolas begin enlarging and filling out.
In stage 3, breasts become more elevated and the areolas continue darkening and expanding. Stage 4 is where the nipples and areolas rise to form distinct mounds projecting from the breasts.
Full maturation is reached at stage 5, usually around age 15-17, where the breasts have attained their adult size and shape with the areolas blending back into the breast contours. However, breasts often keep growing and changing into a woman’s late teens and early 20s.
Sugandhi: When do most girls’ breasts stop growing? I feel like mine kept evolving even after having Aditi!
Me: You’re right, there’s a wide range of normal. A study in Pediatrics found that the median age for achieving breast maturity was around 15-16 years, but it varied from 11.8 to over 20 years old. Pregnancy and breastfeeding also cause breast changes that may remain afterward. And breasts often get fattier and sag later in life due to aging and weight fluctuations.
Aditi: So I shouldn’t be concerned that my asymmetry means my breasts are abnormal or still immature for my age?
Me: Not at all. From everything you’ve described and my examination, your breast development falls within the spectrum of normal for a 20-year-old. Asymmetry doesn’t mean they are under-developed.
Breast Ideals and Realities
Narayan: Doctor, I think part of what’s fueling Aditi’s insecurity is all the media pressure on young women to have large, perfectly symmetrical breasts. She sees actresses and models flaunting their cleavage and thinks that’s the ideal she’s supposed to live up to. As her father, I worry about the impact this has on her self-image.
Me: You bring up an important point about how society’s focus on the female body can breed insecurities. Historically, larger breasts have often been seen as a marker of fertility and femininity. Evolutionary biology suggests well-endowed women may have been viewed as more attractive mates. However, the modern fixation on a narrow standard of large, perky, symmetrical breasts is more a product of media exaggeration than biological norms.
The reality is that breasts come in all shapes and sizes. A study of over 300 women published in the journal Plastic and Reconstructive Surgery found that the average breast volume was about 550ml, but ranged anywhere from 50ml to 2500ml. Cup sizes varied from double-A to double-F. Asymmetry was found in 91% of women, with an average size discrepancy of 50ml.
So women’s ideas of what’s “normal” are often skewed by what they see in media, which tends to feature women with breast implants or extreme proportions. But that doesn’t reflect the wide diversity of natural breasts in the real world.
Aditi: Wow, I had no idea the range was that broad. I guess I just figured most women’s breasts looked like what I see on actresses and models, and that mine were abnormal in comparison. It’s a relief to hear that variation is the norm, not the exception.
Me: Absolutely. And the trend of actresses and influencers showing more cleavage isn’t helping give girls and women realistic reference points. It just breeds more fixation on a narrow beauty standard. But the truth is, there’s no right or wrong breast size, and bigger doesn’t equal better. Plenty of men find smaller breasts attractive and even care far less about size than the media would have you believe.
Finding the Right Bra Fit
Sugandhi: On a practical level, how can Aditi find bras that fit comfortably and look smooth under clothing when her breasts are different sizes?
Me: Excellent question. Well-fitting, supportive bras are key for women with asymmetry. The most important thing is to fit the larger breast first. Look for styles that have stretchy, adjustable cups to accommodate size differences. Padded and molded cup bras can help even things out. Bras with removable pads or cookies that you can put on one side are another good option.
Many brands now offer bras specifically designed for asymmetry, with different cup sizes on each side. It’s also important to get fitted regularly, since size discrepancies can fluctuate over time, especially with hormonal changes and weight shifts. Department stores and lingerie shops often have professional fitters who can assist you.
Aditi: That’s really helpful advice. I’ve been struggling to find bras that fit right and haven’t known where to look. I’ll definitely seek out some of those options and get properly fitted.
When to Consider Surgical Correction
Narayan: Doctor, at what point would breast asymmetry be severe enough to warrant surgical correction? Is that something Aditi should consider?
Me: In most cases, asymmetry is mild enough that surgery isn’t necessary. It really depends on the degree of difference and how much distress it’s causing. A good rule of thumb is if there’s a cup size or more difference between sides, then surgery may be beneficial, either in the form of augmenting the smaller breast or reducing the larger one to achieve closer proportions.
However, I would only recommend considering surgical options once the breasts have reached full maturity, usually around age 18-20, since asymmetry may even out over time. Even then, it’s a highly personal decision with risks and benefits to weigh carefully. I don’t think you need to jump to surgery at this point, Aditi. Better bra fitting and learning to embrace your unique shape are the first lines of approach.
Aditi: I really appreciate you putting it in perspective, Doctor. I feel a lot more accepting of my body after this discussion. Surgery seems extreme at this point. I think I just need to focus on finding bras that fit well and work on my self-confidence.
Closing Thoughts & Advice
Me: I’m so glad this conversation has been helpful for you, Aditi.
To wrap up, here are my key pieces of advice.
1. Remember that breast asymmetry is incredibly common and doesn’t mean your breasts are abnormal or underdeveloped. Variation in size, shape, and position is the norm.
2. Focus on finding well-fitting, supportive bras with features designed for asymmetry, like adjustable cups, removable pads, and different cup sizes on each side. Get professionally fitted to dial in your size.
3. Don’t get caught up in media portrayals of the “perfect” breasts. What you see on actresses and models isn’t representative of the diversity of natural breasts. All sizes and shapes are normal and beautiful.
4. If your asymmetry is causing you persistent distress or pain, don’t hesitate to discuss surgical options with your gynecologist or plastic surgeon. But in most cases, it’s best to let your breasts fully mature before considering surgical correction.
Most importantly, practice self-love, and don’t let insecurity about your breasts hold you back from living confidently. Your worth isn’t defined by your bra size or cleavage. Embrace your unique shape and know that you’re perfectly normal just the way you are.
Aditi: Thank you so much, Doctor. I feel so seen and validated after this appointment. I have a lot more self-acceptance and practical strategies now. I appreciate you taking the time to really hear me out and give such thoughtful guidance.
Sugandhi: Yes, we’re so grateful for your compassionate expertise, Doctor. As a mother, it puts my mind at ease to know my daughter is getting the right support and information about her body.
Narayan: Agreed, we feel very fortunate to have you as our family physician. Thank you for always going above and beyond for us.
Me: It’s my pleasure. Never hesitate to come to me with any health questions or concerns, no matter how sensitive. My door is always open. Aditi, I hope you leave here today feeling more informed, empowered, and at home in your own skin. Remember, you are beautiful and worthy, just as you are. God bless you.
