Is It Normal for One Breast To Swell More than the Other After Breast Augmentation?

I had breast augmentation 4 days ago, I was originally a 34B / 36A. I chose 450 CC implants for the surgery. Looking at my breast now it appears one is larger then the other- is it normal for one to swell more then the other? if you had to guess, what size do you predict I will be once all swelling is gone and do you think my breasts will even out in size?

Doctor Answers 15

Normal for one breast to swell more than the other after BA

It can be totally normal. were your breasts the same size before the surgery, were the same size implants used. It is not uncommon for the dominant hand side to seem bigger due to the thickness of the muscle, and the muscle not "liking it". I would return to your surgeon and ask their input and advice.

Norwalk Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Breast implant asymmetry/size after augmentation?

Thank you for the question.

Some degree of asymmetry is a common 4 days after breast surgery. Unfortunately there is no way to know what cup size you will end up filling.

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.


Asymmetrical swelling common after breast augmentation

It is very common for one breast to be affected by swelling or than the other. Swelling usually subsides within a few weeks after surgery. While it is difficult to say what size you will actually be after the swelling subsides you will most likely be around the size you wanted to be since the implants were selected for that purpose. 

Implant differences

All breasts are a bit asymmetric.  At 4 days it is very hard to tell what the final shape will be. Unless there is a huge difference, with pain, and bruising, it is more likley routine post-op swelling.

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

Asymmetric swelling after augmentation

It is very common for your breasts to swell unevenly after augmentation.  It takes a full month for the implants to relax down into the pocket and look good - this also happens asymmetrically - so one may look higher or lower than the other at times.  It takes 3 full months for all the swelling to resolve and the breasts to get soft and natural feeling - then you look great!  Good luck.

Uneven breasts after BA

No woman's breasts are perfectly symmetrical.  70% of woman have a larger left breast.  If the same size implants were used in both your breasts you should have no more volume difference when all is said and done (4-6 mpnths) than you did before surgery.  The swelling right after surgery can be uneven, but there is always a concern about bleeding and a hematoma.  If the difference is a lot you should see your surgeon soon for evaluation.  Otherwise time should even things out more.  As to size.... well so many variables enter into it that no one can say what cup you will be except that it should be more than  you started with.  You could end up with anything from a C to a DD.  Your surgeon should be able to tell you more precisely since he/she has the advantage of knowing your body measurements and tissue characteristics.

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 13 reviews

Not uncommon to have uneven breasts immediately after surgery

Your breasts may swll differently after surgery and in particular the position of your implants with one higher than the other is even more common.  This will improve in short order.  However, your uneven swelling may also represent a hematoma or blood collection.  Make sure you see you plastic surgeon regularly to be evaluated.

Healing after breast augmentation

the two breasts frequently swell differently.  if they were symmetric before and the same size implant was used. they will have equal volume after they heal

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 26 reviews

Asymmetrical Swelling After Breast Augmentation

It certainly is not uncommon to have some slight difference in the amount of swelling between the breasts following augmentation mammoplasty.  However, if there is a marked difference in the degree of swelling, it may be caused by a hematoma (especially if accompanied by a good deal of pain).  If this is the case, you should inform your surgeon immediately.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast Asymmetry Early After Augmentation

It is very common in the early recovery from breast augmentation to have the two sides "behave" differently.  As a surgeon, I go to great lengths to try to get the two breasts to look as much alike as possible during surgery. By the next day one side may hurt more,may be more bruised, or have muscle spasm, or just have more difficulty getting used to the new implant.  Tha difference usually settles down within a few weeks.  Small differences are normal.  Large differences might mean a fluid collection  or hematoma.  Make sure you review your concern with your surgeon so he or she can make sure your progress is normal.

Mary Lee Peters, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 97 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.