Very Asymmetrical After BA; Any Recommendations for Revision Surgery? (photo)

Had BA/BL Oct 2012. 650cc Style 20 rt side; 420cc Style 10 on bigger left side; overs. Left is flat, and the breast tissue settled at bottom of implant. Feels like implant is attached to my chest wall–soft but doesn't move around. I can push my breast tissue up onto the implant when lying on my back. PS lollipop lifted left side; still saggy. Right is getting softer but is tight b/c skin hasn't stretched yet. I am happy w/rt side. PS picked out styles/sizes of implants. Any revision thoughts?

Doctor Answers (15)

Asymmetric breasts.

+1

The results you have will not correct themselves over time. In order to improve the symmetry, you require a larger implant on the left and a revision of the mastopexy. A conversion to an anchor scar mastopexy is also quite likely. Sizers in the operating room are essential in a case with this much asymmetry. I would recommend waiting at least 6 months prior to a revision however.


Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Significant asymmetry before and after surgery

+1

When a patients breasts are very asymmetric, the case is certainly more challenging and obtaining perfect symmetry may not be possible. I rarely use sizers during surgery but in your case I would have before choosing the implant size. I dont know if your surgeon did but it would have been helpful. Realize that this can add to the cost of the procedure. Once the correct implants are chosen, the lift would be done. It appears that you need more of a lift on the left side. The implants also need to be changed, either larger on the left or smaller on the right, if you want better symmetry. I would also add that when I see patients with similar levels of asymmetry, I let them know up front that they will not be exactly symmetric no matter what I do, and that there is some chance that a second surgery may be required to improve on the result. Best of luck.

Paul Wigoda, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast lift

+1

Your left side was not lifted enough and needs to be lifted further. I also think the implant sizes chosen were too large.  Will be easier to achieve symmetry if you stick with smaller implants, such as the mid 300 cc range.  You should wait about six months after your first procedure before re operation.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Very Asymmetrical After BA; Any Recommendations for Revision Surgery? (photo)

+1

I commonly use adjustable implants when correcting asymmetry , especially in revision cases

You will also require a revision mastopexy on the left 

Hilton Becker, MD
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Lift revision helpful

+1

Thanks for your pre/postop pics. It is helpful in addressing the questions you pose. Because of the existing asymmetry preoperatively, this was very challenging. I'm concerned about the large volume on the right and the long term consequences of having this heavy device stretching your breast gland and skin. I agree with others' comments that the left could be revised to improve the position of the nipple areolar complex. The implant volumes need to be closer to improve the volume symmetry. Best of Luck!

M. Scott Haydon, MD
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Very Asymmetrical After BA; Any Recommendations for Revision Surgery?

+1

It appears that you have 2 issues.  First, the left side is still sagging more than right side.  Need to have lift redone on the left.  Second issue is the size of implants - you have a much smaller implant (volume), on the right and also, they are different style implants.  You will probably need to with a higher profile implant (style 20), to get the size more equal.  You should dicuss both issues with your plastic surgeon.

Rigo Mendoza, MD
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Asymmetrical after augmentation

+1

Thank you for your question and pictures.  Your pre-operative photos demonstrate a significant difference in both the shape and size of your breasts.  This difference creates quite a challenge when trying to make the breast match after an augmentation and a lift.  At times, a revision of the lift may be required, plus or minus and implant exchange for a different size to add more volume.  You will most certainly need a revision of the lift on the left side, the timing of which can be determined by your and your surgeon.  You will likely also need more volume in the form of a larger implant to make the sizes of the breasts more similar.  Best of luck!

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
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Postop asymmetry

+1

Agree with the other PS here. Your preop asymmetry was very significant. the degree of ptosis ( sagging) would have been better served with a full mastopexy and possibly a mild reduction to help with the size mismatch. 
it's important to recognize that no one is perfectly symmetric and this degree of asymmetry may take a revision procedure to improve. Be patient with your ps and let him / her know your concerns.
My preference would have been to use the same implant, with a reduction / lift on the left to better match the right. Hope all turns out well for you.
Bennett Yang, MD Washington DC

Bennett Yang, MD
Rockville Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast asymmetry after augmentation

+1

Thank you for your question and pictures. I would recommend performing a full lift (Inverted-T) on your left side to lift the areola and breast to match the level of the right. I would also recommend changing to a larger and high profile implant on the left to match the projection and size of the right. I think the discrepancy between implant sizes and styles may have been too much. Please consult with your surgeon. 

Moises Salama, MD
Miami Plastic Surgeon
4.5 out of 5 stars 783 reviews

Revision of breast surgery for asymmetry

+1

You had a marked degree of asymmetry prior to surgery.  It appears that the asymmetry was not totally corrected with your initial breast lift procedure.  In order to establish better symmetry you will definitely need a revision of the breast lift and there is a possibility that you may need a larger implant on the left.  Your plastic surgeon is in the best position to determine what is needed as well as the timing of revision.  

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