I am 2 months post op 420 filled to 440cc saline high profile mentor smooth implants set under the muscle. I am 35, 110 lbs, 5'2". My left breast is significantly different than the right. They are uneven even in a relaxed state, but (as seen in the photo)when I flex the pectoral muscles, there is an obvious bump only on the left side. What has happened with the implant and the pocket, and what can I do now?
What Has Happened with my Implants to Result in Such a Difference?
Doctor Answers (19)
Left breast implant has failed to drop and revision may be needed
Thank you for your question. The left breast implant has not descended into a symmetrical position with the right side. Although it is early in your postoperative. I would've expected more descent on the left than you have at the present time. Meet with your plastic surgeon and express your concerns. Most likely a revision will be necessary if the implant does not drop soon, however I would wait 3-6 months before a revision.If the left side feels firm, hard in the implant does not move, you may have a capsular contraction although it is early for that to occur.
Breast asymmetry 2 months out
The left implant is sitting too high and will not drop into an anatomic position without surgery. This is probably attributable to a component of capsular contracture. I would approach this performing an inferior pole capsulectomy. This involves removing the lower half of the capsule surrounding the implant and redefining the lower limits of the pocket. The implant should be centered on the nipple.
Revision breast augmentation works.
1) If you looked like this from the beginning, the left breast implant pocket may have been made too high. If this just happened, a severe quick capsular contracture is possible. Even if your breasts were a little different before surgery (most women have a little asymmetry), that would not explain how you look now.
2) In a sense the cause does not matter. The fact is that your left breast is too high and too narrow. I would not do anything for another four months. But I am afraid that you will eventually need a revision.
3) Exactly what should be done depends on physical examination, but at a minimum the left implant pocket needs to be lowered and widened.
4) Each plastic surgeon has his or her own policy about revisions. When doing breast augmentation in New York City, we do not charge a surgical fee for revisions done within a year, but you do have to pay for the operating suite, and for the anesthesiologist.
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Breast asymmetry after augmentation
It appears that your left breast has not descended into the proper pocket after surgery. Depending on the tissue condition, this may be improved by massage or a breast band. You may also have an early capsular contraction which would possibly require revision surgery. See your surgeon for re-evaluation. Donald R Nunn MD Plastic Surgeon.
Fixing implant malposition
Your left implant is sitting to high. Irregardless of the underlying cause, if the implant doesn't settle, you would likely need to have the implant repositioned. Implants can take up to six months to settle. Applying pressure in to the superior pole of the implant my help stretch the inferior pole soft fishes and assist the implant in settling. Also, wearing a bandeau support may help the implant settle without surgery. However, looking at your photos, I suspect you will need revision surgery. I would suggest you consult with your surgeon regarding the best option for you.
Significant breast asymmetry
If this has been like this since the time of surgery, it is likely that the two implant pockets were created unevenly
If the right breast descended but the left stayed up high it is possible that there is something on the left side that was not completely released and did not allow your implant to settle into it's proper position
If the left side seemed to rise over time you may have developed a capsular contracture, although it's a little early for that.
Whatever may be going on, the difference between the two sides is too big to leave it alone. You should talk to your surgeon or another board certified plastic surgeon so that he/she may examine you and treat you. You will need a corrective surgery to give you better symmetry.
Martin Jugenburg, MD
Asymmetry after Breast Augmentation
Thanks for posting the pictures. It makes answering your question more useful and informative for other patients. Your left breast implant, as you describe, is to high. As others have said, it appears that the pocket on the left is malpositioned and the implant did not settle the same as the right. Additionally, there may be a component of capsular contracture, but that cannot be determined by photographs alone. Did the implants start out even, but the left one raised up on your chest wall. Or, were both implants high and the right one settled further? Hopefully you are able to discuss your situation with your surgeon.
Breast Augmentation Asymmetry
There are many possible explanations for your breast augmentation asymmetry and you may never know exactly why but the important thing is you need the left fixed. The left breast will need a small revision of the lower pole to get that implant in a position that approximates the right side. This is usually a simple operation. I am sorry that you have to go through that but you should still get a very nice result.
Breast asymmetry after breast augmentation
After breast augmentation it is possible to have asymmetry of the implant pockets. In your case, it appears that the implant did not settle into its pocket or the pocket was created too high on the left. If there was significant swelling and busing of this side immediately after surgery, a hematoma may have played a part.
It is too early to decide whether this will require additional surgery or not (although it is a fairly significant asymmetry and I would guess that it will eventually require revision). Revision should wait a few more months for accuracy.
I would recommend that you visit your plastic surgeon.