Natural Look for Uneven Breasts - Type of Surgery?

What surgery would you suggest for me? I clearly have asymmetric breasts and I would like to know what surgery you would advise? I have realistic expectations and know that its not possible for 100% asymmetry. Im looking for a natural look that will even out my breasts the best they can be.

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Natural Look for uneven breasts

Yes, you can have a natural look and breast augmentation surgery can make your breasts more even, but probably not perfectly symmetrical.   I have attached a link to my before and after breast augmentation gallery. If you look at the results, most look symmetrical, but sometimes, there is not perfect symmetry.

In many breast augmentation patients, like the photo you have included, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold. Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).
You will likely require different sized breast implants but the result can be beautiful/ My photo gallery included women who started with uneven breasts and women with tuberous breasts. You can see what the possibility is for you. 

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 48 reviews

How to Fix Uneven Breasts

  1. First decide if you like one of your breasts as it is now.
  2. If you like the right breast, then you would benefit from a Spectrum implant placed in the left. This is a postoperative adjustable implant from Mentor.
  3. If you like the left breast, then you would need a reduction of the right side.
  4. If you do not like either breast then decide what you want, larger, smaller, or in between.

An experienced plastic surgeon can do a variety of things to make your breasts more symmetrical, but they will never be identical. Be sure to sit down and discuss your options with several different surgeons and choose the surgeon you are most comfortable with.

Good luck.

Suresh Koneru, MD
San Antonio Plastic Surgeon
5.0 out of 5 stars 10 reviews

Uneven breasts

Thank you for your question. It appears from your pictures that you have nipple and size asymmetry. If this is the case you will need a slightly larger implant on the smaller breast and a breast lift to achieve symmetry. If you like the size of your right breast then you will only need an implant on the left side.  It could be that the left breast has some constricted breast tissue and this will need to be released at the time of the surgery probably with a dual plane approach. Good luck and I recommend that you visit with a board certified plastic surgeon who has extensive experience with breast asymmetry.

Best way to approach breast asymmetry

I think the best way to approach correcting breast asymmetry is to have realistic expectations as to what can be achieved. Although no one can expect to achieve perfection, realizing that significant improvement can be achieved should be the goal.

Sometimes, breast asymmetry is approached in a staged fashion. First you should decide which breast you like best and discuss with your plastic surgeon how you can best get your opposite breast to match. This may require an implant, reduction, lift, or augmentation with lift. Sometimes, it is easier to correct one breast to best match the other, even if this is not the breast you like best. Other times, you may need to have both breasts addressed.

Because there are so many variables and options, I would recommend scheduling a consultation with a board certified plastic surgeon for an evaluation and to discuss your options. This is the best way to see what can be accomplished and to make sure you are comfortable with your surgeon as well as the proposed surgery.

Good luck!

David A. Robinson, MD
Munster Plastic Surgeon
5.0 out of 5 stars 17 reviews

Evening out asymmetry

You can have an implant in the smaller breast to balance them out or a reduction in the larger one. Or, you can also have two different sized implants if you want bigger breasts overall. Talk to a board certified plastic surgeon for more advice.

Breast asymmetry can be corrected

Breast augmentation can definitely help you achieve better balance between your breasts. You can choose to have one breast implant to bring it up to the size of the larger breast, or two implants of different sizes to make both breasts bigger. The choice is up to you.

Uneven Breast Surgery

Asymmetry is common in most women, but is subtle.  More pronounced asymmetry may be a form of congenital breast disorder such as tuberous breast deformity or the extreme Polands syndrome.  Some insurance carriers allow breast reconstruction for these patients and you can check with your company.  Surgery is designed to create symmetry and typically involves gel implants, fat grafting or both with various surgery on the opposite breast for symmetry.

Making breasts more even

As I look at your picture, I notice several findings that will need to be addressed to make your breasts more even.  The right breast is larger than the left and the nipple position is lower than the left.  You have more "ptosis" on the right side, which is the sagging of the breast and no ptosis on the left side.  You will need to have all three things corrected in order to become more even.  This can involve a lift or a lift with a small reduction to reshape and resize the breast to better match the left.  BUT, you also need to think about your planned size outcome.  Do you like the volume of the right breast (the way it fills out your bra) or do you wish to be larger?  Do you find the left breast too small for you and out of proportion with your body?  Then you need to think about augmentation.  Sometimes the best approach is to do ALL of the procedures, lift and reduce the right breast and then augment both breasts so that the shape and size and nipple height are more even.  You will have to accept more scars on the right breast than the left to achieve this goal.

Think about the way you want to look at the conclusion of surgery.  Then find a good,reputable plastic surgeon with whom you can discuss your wishes and who can realistically go over the options with you.  Breasts with as much asymmetry as yours can never be exactly the same, but they can look more even both in and out of your clothes!

Catherine T. Milbourn, MD, FACS
San Antonio Plastic Surgeon
5.0 out of 5 stars 4 reviews

Uneven Breasts

First of all, you should know that every woman has asymmetrical breasts to some extent. Surgery can definitely help them look more even, although you’re wise to understand that “perfectly even” isn’t a realistic expectation.

There are a lot of different breast enhancement procedures that can help your breasts look more symmetrical. If you want to go larger on both sides, one implant can be smaller than the other to compensate for the breast that’s naturally larger. If you’re happy with the natural size of the larger breast, then only one implant could be used. A surgeon could also perform a breast reduction to reduce the larger breast down to the size of the smaller breast. Finally, a breast lift can help ensure that the position and placement of both breasts is as close to even as possible.

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.