I want to even out my breasts, so I am getting implants. With differently sized silicone implants (I do not want saline), can I get a result that is mostly symmetrical? (Meaning any remaining asymmetry is only noticeable to me or someone looking for it?). Is it possible for me to only go up 1 or 1.5 cup sizes? Can I expect a natural-appearing result without a wide gap between the breasts/an overly round-on-top appearance, based on my photo?
Will I Have a Good Result with Differently Sized Implants? (photo)
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Perfect symmetry with breast implants.
Thank you for your question and for your photographs. It looks from your photographs as though you have slightly more volume in your left breast. The left nipple and areola are also somewhat higher than the right. In a situation such as yours I find it helpful to try on implant sizers in the office preoperatively. With a silicone gel implant you are limited in the adjustments that can be made because they, sealed, as opposed to a saline implant with the volume can be adjusted in surgery.
By looking at implants on you in a bra before and it can help to determine whether a larger implant on the right side will bring you closer to your volume goals or actually tip you and the other direction making the right breast larger.
From your photo, one size up on the right side may be beneficial for you. But you must understand that there are always certain tradeoffs. The next larger silicone implant will have a slightly wider diameter. Generally in this situation this is something that you may notice but others usually wont. A larger implant and the slightly smaller breast may look tighter and firmer for a while because it will take more time with a skin on that side to relax.
While you have slight nipple and areolar height asymmetry I would not recommend you do anything about it. While nipple height can be adjusted the scars associated with the adjustment often draw more attention than a slight normal natural asymmetry.
I hope this helps.
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Different sized breast implants
There are several issues/questions to address:
The problem with asymmetry of the breasts is that it is not purely volume which is the only thing an implant adds. Differences in shape, position, direction, and nipple-areola can all add to asymmetry and even the perception of size. Another problem is that we don't currently have a simple way to measure the volume of the breast even though we know the volume of an implant. Also, volume comes in three dimensions and round implants only come in a limited number of options for forward vs. diameter measurements. Saline-filled implants can be varied in volume between their rated volume and about 10% more and still be filled properly (one of their minor advantages). Silicone gel-filled implants cannot be adjusted in volume, at least those available in the US. I would disagree with the suggestion for external sizers as they really don't help decide the issue of the proper size implant in any realistic manner.
If a saline-filled or gel-filled implant is matched to the width of your breast and positioned under the pectoralis muscle for the part of the breast it covers, then the lowest profile implant will make your breasts look about a cup size larger. If you choose a middle profile implant then the increase will be about 1 and 1/2 cup sizes. High profile implants scaled to the width would make you look about 2 cup sizes larger. If your right breast was a full 1/2 cup size smaller than your left, then a medium profile on the right and a lowest profile implant on the left would balance things with the width of each implant being the same. Currently, if a larger gel-filled implant of the same profile is placed on the right than on the left, it will also be wider, and different width breasts is not adding to symmetry.
Naturalness is a vague concept but generally it means that the implant fits properly behind your breast and makes it look like a larger breast, not a breast and an implant. If the implant is sized and positioned properly (under the muscle), the gap between your breasts should be the same as it is now with steeper cleavage. Avoiding a high profile implant should avoid overprojection in the upper pole of the breast.
I would not vary the size of gel implants more than one notch for this degree of asymmetry. If the implant doubles the size of your breasts using the same volume implant, then the difference between your breasts is decreased by 50%. I would at least consider saline-filled implants where the volume of one implant can be varied by at least 10% while keeping the width of the implant about the same.
Breast Size Discrepancy and Different Breast Implant Sizes
A small breast size discrepancy can be improved with slightly different volume implants. Subtle pocket changes during the dissection can improve asymmetry of the breasts. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year. Kenneth Hughes, MD breast implants Los Angeles, CA
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Correct asymmetry with Mini Ultimate Breast Lift
You state that you want to even out your breasts so you are getting implants. However, it is possible to even out your breasts without implants. Your photograph shows your right breast is slightly lower than the left. It is possible to elevate both breasts higher on the chest wall, increase your cleavage, increase your projection and reshape your breasts. All this can be done only with a circumareola incision and without implants. If you are happy with your size then implants are unnecessary but if you do want to go up 1 to 1 1/2 cup sizes a small implant can be placed through the same incision. I recommend silicone gel implants placed retro-pectoral since they look and feel more natural. You may to a candidate for a new technique called The Mini Ultimate Breast Lift.
Gary Horndeski, M.D.
Breast Asymmetry and Implants
Your breasts are very nicely shaped and mildly different in volume. Breast asymmetries are very common and very normal. Some of your volume asymmetry can be corrected with different sized implants. However, realistically, you should not expect full correction. A 1-1.5 cup size increase is very reasonable. Good luck!
Breast Implant Symmetry
I think you can get a great result. To prevent a gap, pick an implant with width close to your natural breast. You can use two different size silicone implant to match volume. In my office, I like to use 3D computer images of each patient to assure that they like the size and symmetry. It allows to simulate different sizes and styles of implants in your own body.
Asymmetry and correction with implants.
The questions you pose boil down to one thing: a natural breast augmentation with improved symmetry. The short answer is yes! A moderate increase in breast size, the use of different sized implants, and keeping the implants well within the scope of your current breast dimensions can achieve this for you. The gap between the breasts is already predefined by your anatomy. Your expectations are realistic and you should expect great results!
Symmetry with Different Size Silicone Implants
Most women have a modest difference in size between their 2 breasts, as you do. With silicone implants, one would need to use a slightly larger implant behind the smaller breast to compensate. Implants come in different widths, projection, as well as size (volume), and an experienced surgeon can help you choose the most appropriate combination of implants to give you the closest symmetry. Also, it is certainly possible to go up only 1 or 1 1/2 cup sizes. You get to decide how much of an enlargement you receive. Concerning the gap between your breasts, this would be reduced following an augmentation, but there is a natural limit to how close we can place the new implants. You should look very nice with a natural result.
Using different implant sizes is definitely an option for you as you appear to have volume discrepancy. However, this is a much easier task with saline implants as silicone implants come in discrete sizes. After you have an estimate of the size and shape implant you like based on external sizers, your surgeon should have a series of implants available and use internal sizers at the time of surgery to choose the right set of implants for you. The decision of the exact implants to use will have to be left to your surgeon and his judgement at the time of surgery.
Symmetry with Breast Augmentation
I believe all of your goals are possible to achieve but cannot be guaranteed. Your best chance of having a result that you desire is to find a board certified plastic surgeon who is experienced and will spend time with you. Make sure you speak openly about your goals and that your surgeon is attentive to what you request but who also is realistic in describing possible results that may be less than optimal. Good luck.