Breast Augmentation for Asymmetrical Breasts?

I'm considering Breast Augmentation. I'm 5'2" 107lb, 34B, left breast is slight bigger(50-100cc?). So it's a bit saggy than right, left nipple is about 1cm lower than right nipple. What is the best way to fix this asymmetry beside put in different size implant? (I'm thinking about silicon, R 290-330 L350-370 ).

Or if by putting different size of implant can balance them out? Is areola incision the best way to go to take off a bit skin on left breast on top of nipple?

Doctor Answers 11

Ueven breasts and how to correct breast asymmetry with implant augmentation

A left crescent lift with volume compensation using different sized implants or suction assisted lipectomy (liposuction) of the larger left breast with similar sized implants are reasonable options for correction of the breast asymmetry. I have prepared a series of 4 youtube videos (linked below) discussing the management of breast asymmetry.

Chicago Plastic Surgeon
5.0 out of 5 stars 54 reviews

Have a question? Ask a doctor

Breast augmentation

Without the benefit of photos it is difficult to give meaningful advice.  Having different sized implants to balance out the breasts is only one way of having symmetric appearing breasts.  Breast are less frequently even than one thinks.  There are many factors:  looseness of the overlying skin/breast, location of the nipples, prior pregnancy, age,etc.  

Shahin Javaheri, MD
San Francisco Plastic Surgeon
3.5 out of 5 stars 2 reviews

Asymmetry and augmentation

Yes, you can correct different sizes by placing implants of differing sizes. We do it all the time. It seems like you're very decided on the size. Hopefully your ABPS board certified plastic surgeon and you have discussed this in detail and he's come to that conclusion with you. Sometimes the asymmetry cases can be really tough because there's always going to se somewhat of a difference, but it can be made lesser. If the patient has that expectation you'll be alright. Sometimes it comes out just perfect!

As far as the lift goes, that's a trickier issue. Some of the periareolar lifts don't really work well at all. There are various techniques in lifting that can reposition the areola and nipple very effectively. Again, in this situation they can be positioned almost perfectly if the proper lift technique is done. Your plastic surgeon will know which lift technique has worked out best in his hands. I suggest you openly discuss your concerns with him prior to having surgery. This may entail a second preoperative visit. They're not uncommon and can be very helpful to clarify expectations.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 75 reviews

Asymmetry and breast implants

 If there is significant asymmetry of the height of the nipple areola complexes, then a simple areola lift can be performed to raise the nipple areola complex and match the size to the opposite one.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Implants and lifts for asymmetry

What asymmetry you have cannot be corrected with implants alone.  The one side needs a lift.  Maybe both do and you would have the same scars.  Minor lifts can be done with areolar scars without the vertical scar or one in the crease.   

Breast Augmentation for asymmetrical breasts

The vast majority of women have Asymmetric breasts. Asymmetry is the rule not the exception. There your situation is rather common.

My preferred incision is periareolar since it allows modification of the areola, visualization of the entire pocket and is re-useable in the future.

I would approach your condition by measuring the base of your breasts and see how much cover they can afford the implants. I would do a breast augmentation bilaterally using sizers to give us the best approximation of the ideal size implants for each side. Once the augmentation stage was over, I would perform a lift on the droopier side as dictated by the implant placed.

Although discussions of cc's (silicon, R 290-330 L350-370), are important conceptually, I would defer all my final decisions BASED on these discussions, to what I see in the OR.

Hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 69 reviews

Breast lift versus breast augmentation

When there is a discrepancy in size between the two breasts, then using different size implants (a larger implant is placed under the smaller breast) can help even out the sizes. However, if there is a discrepancy in the level of the nipple-areolar complex, then you may also need a breast lift at the same time. If you post pictures, we may be able to give you more specific advice. Good luck with your procedure.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 61 reviews

Breast asymmetry treatment options

Breast asymmetry is extremely common. In fact it's probably the norm rather than exception. Generally we accept is small amount of asymmetry. When the asymmetry is significant then using different implant volume can make the breasts look more evenly matched in size. Based on your description it appears that you have both size (meaning volume) and shape (meaning location of nipple and/or breast tissue) asymmetry. Using breast implant alone may only correct the volume difference but not the shape. You may benefit from a breast lift to correct the nipple position difference.

Generally, if I need to correct nipple/areola position then the circumareolar incision is used to allow for remove of skin, placement of implant, and closure which will result in a circular scar. Your situation is quite common. Often time, a woman may not even realized it until the asymmetry is pointed during your consultation with a plastic surgeon.

I always tell my patient that breasts are like sisters, not twins. You want them to be quite similar but they wouldn't be identical.

Good Luck with your procedure!

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.5 out of 5 stars 24 reviews

Significant Breast Asymmetry Usually Requires A Lift

So it's hard to say without seeing your photos. Most women have breasts that do not perfectly match, and in many cases it's because there is more skin and sagging on one side versus the other.

In cases where there is a big difference in the length of the folds beneath the breast or in the height of the nipples, a lift may be needed.

Sometimes there is simply more breast tissue on one side versus the other, and if your "skin envelope" is about the same on both sides, different sized implants may provide you with sufficient correction.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 193 reviews

Breast and nipple assymetry

For breasts that are different sizes, I prefer silicone gel implants over saline implants because I find the silicone implants to be more forgiving. If you try to improve size asymmetry with saline implants by putting more saline on one side, that side will be firmer and rounder than the other side.

As to nipple asymmetry, it is up to the patient to decide if the additional scarring that you incur when moving a nipple is worth it. In my experience, "crescent" lifts (scar only on top of the areola) don't do much more than distort the areola. The only lifts that successfully change the nipple location involve at the minimum a scar all the way around the areola (peri-areolar mastopexy), or around the areola and down the front of the breast ("lollipop lift"), or the typical anchor scar of a full lift.

Marcel Daniels, MD
Long Beach Plastic Surgeon
5.0 out of 5 stars 20 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.