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Asymmetric Breasts - What is the Best Placement for Breast Augmentation? (photo)

I am 29 years old, 2 breast fed children (5 & 8 years old currently) 5'9 tall, 152 pounds. I lift weights however happy not to do direct chest exercises as I like the under muscle look. I have been to see 2 PS and they have both given very different responses on how to make my breast as close to symmetrical as possible without a full Breast lift as I scar badly. I like larger sized breasts as my left is a C and right is a B. I am interested in gaining another perspective, pros and cons. Thanks.

Doctor Answers (15)

Augmenting Asymmetric Breasts

+2

Dear Maryanne,

Your case is a very interesting one and you have now discovered why plastic surgery is as much an art as a science.  Methods that are effective for one surgeon, may not work for another surgeon, and vice versa.  I would question what you mean by "I scar badly" and how you have made that discovery.  I would also question what your definition of a "full Breast lift" is, as there are now several breast lift techniques available that minimize the scarring.  In my opinion your best option is augmentation of both breasts with a periareolar (around the areola) lift on the left breast.  Good luck!


Manhattan Plastic Surgeon
4.5 out of 5 stars 31 reviews

Breast asymmetry

+2

Since the breasts are paired organs, it is ideal to do similar procedures. The difference appears to be in breast volume and in skin surface area leading to ptosis or sagging. What you require to achieve symmetry will be dependent on what your goals are. For example, if you wanted to would avoid implants, you need a lift and small reduction on the left. The larger you go, the less the skin difference would be since the implant will start to override your normal anatomy. It might be possible to go so large that the skin difference will be minimized. However, I suspect that by normalizing the left breast with a small reduction/lift, you could then simply augment using the same style and size of implant, which would be ideal.

Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

Improving breast asymmetry

+2

Thank you for your pictures and your question.  Based on your pictures, it appears that you would benefit from a breast augmentation only to the right breast and a breast augmentation with a limited breast lift to the left breast.  You will likely need slightly different size implants along with shape of implants.  However, despite these maneuvers you will continue to have some asymmetry as the shapes of your breasts are quite different.  Manage your expectations and be mindful of any surgeon who promises symmetry with surgery.  Good luck!

Naveen Setty, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

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Improving Breast Symmetry with Breast Surgery?

+2

Thank you for the question and pictures.

Based on your pictures, I think I would offer you bilateral breast augmentation as well as a limited breast lift on your left side. It is very likely that the breast lift on the left side can be a circumareola (Benelli)  breast lift ( with resulting scars around the areola only).

It is also very likely that you will benefit from different sizes and/or profiles of breast implants to help improve the breast symmetry.

 I would suggest that you continue to do your due diligence and be very careful  in the selection of plastic surgeon. Communicate your goals carefully; in my practice I prefer the use of goal pictures to help with this communication process.

 Of course, in person consultation will be necessary to provide you with more precise advice.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 710 reviews

Breast augmentation in asymmetric breasts

+2

Thanks for your question.  In patients with asymmetric breasts it is important to address the issues that are creating the asymmetry.  If there is simply volume asymmetry then different sized implants can improve the problem.  If there is a difference in the position of the chest wall, say one side is depressed compared to the other, then a combination of different sized and different shaped implants may be helpful.  If there more skin on one breast and the nipple hangs lower then sometimes doing a "dual-plane" dissection can improve the problem, but often a breast lift will be more effective.  A breast lift can involve many different things--from an incision around the areola to one that involves an "anchor-incision".  Based on the pictures that are presented, it looks to me a dual-plane dissection on the right with a left periareolar mastopexy and likely slightly different sized implants will improve the asymmetry.  Good luck with your surgery.  Keep your expectations realistic and you will be happy.

Jason E. Leedy, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 28 reviews

Asymmetric breasts - what is the best placement for breast augmentation?

+1
Hello! Thank you for the question! The typical incision used for breast augmentation are: inframammary (in the fold beneath your breast), periareolar (at the border of the areola), axillary (within the armpit crease), and TUBA (through the umbilicus). Incision placement will do a lot with your preference, surgeon comfort level with that approach, and the type of implant - silicone implants will be difficult to place within certain access incisions. Breast augmentation scars are well concealed and are very discrete. They should not be visible within clothing, and likely hidden without clothing. If your concern is the visibility without garments, you should consider remote access incisions such as in the armpit. However, these other incisions heal very well on the breast and often times inconspicuous. 

Consult with a plastic surgeon your goals, concerns, and expectations. Certainly incisions should be considered, but should not limit your overall result by hindering visualization and access to your surgeon, and what produces the best results in his/her hands.  Given your photos, you do have a degree of asymmetry as well as drooping of your breasts.  You may be well-served with a breast lift in conjunction with an implant.  If you refused a lift, I think you will likely need a large, highly projecting implant to hopefully provide enough projection to lift the nipple-areolar complex. 

Hope that this helps!   Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast Asymmetry And Breast Implants

+1

    The breast asymmetry can be managed with a larger implant on the right and a smaller implant on the left.  In addition, a circumareolar lift on the left would help to improve symmetry.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 194 reviews

Breast lift with a breast augmentation for asymmetric breasts

+1

This type of breast asymmetry is not uncommon and presents several problems for both the patient and the plastic surgeon.  Your right breast will do great with a standard breast augmentation however an augmentation on the left will not yield the same result.  You have enough sagging on the left side to justify a breast lift.  I would look at your procedure as a breast lift first and a breast augmentation second.  Once the skin envelope of the left side is corrected then a breast augmentation will complete your result.  Even using large implants without a breast lift will, most likely, give you overly large and disproportionate breasts.  Hopeful your scarring can be kept to a minimum using standard plastic surgical techniques.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Asymmetry

+1

All women have some degree of asymmetry. Yours may be a little more pronounced on the left. You will be much improved with bilateral augmentation with the proper sizing and shape implants and a peri areolar lift on the left which will minimize your scars.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

Asymmetric Breasts - What is the Best Placement for Breast Augmentation?

+1

Great questions and example- thanks for sharing. Regarding implant position, there are many benefits to implants under the muscle and fewer disadvantages. Under the muscle is a good choice and will not limit you from being physically active.

Your breasts have pretty significant asymmetry of shape, size and nipple position. I think it is unrealistic to expect to improve asymmetry without a lift of some sort on the saggier side. Your surgeon may be able to achieve adequate symmetry with a doughnut-type or Benelli lift. This would avoid the upside down T scar and limit the scar to the circumference of your areola.

A larger implant in the smaller breast may help improve size asymmetry.

Best wishes,

Michael Vennemeyer, MD

Michael Vennemeyer, MD
Southlake Plastic Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.