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Hi, I'm Dr. Adam Oppenheimer. I'm a plastic surgeon in Melbourne, Florida. This is a question about breast asymmetry early in the postoperative period. Anytime I see breast asymmetry early in the postoperative period, I'm always concerned about the possibility of bleeding into the breast. This is called a hematoma. A small hematoma is something that can generally be observed and is self-limited. It may cause an increased risk of scarring around the implant or capsular contraction over time, but it isn't a cause for immediate re-operation. In those kinds of patients, I would want to see them very regularly in my office to make sure that there is no increasing pain or increased stretching of the skin, which would mean there could be ongoing bleeding, and then I would need to take them back to the operating room.

The other possibility however is related to pec spasm or the pectoralis muscle spasm. When implants are placed over muscle, this is not an issue as much, at all actually, and the implants are more likely to be able to drop sooner. When implants are placed under the muscle, the pectoralis muscle can spasm and this can hold the implants up a little bit higher in the chest. Sometimes after surgery if the implants seem to be higher or if the pec muscles seem to be very tight, I'll help my patients by putting a bandeau or a bra band just on the upper portion of the chest. This can help the implants settle down into place.

The other thing about early postoperative asymmetry, with one implant being slightly higher than the other, is that it's really too early to tell. In some patients who have a more well-developed muscle or other issues anatomically on one side or the other, implants may take a little longer to drop on one side than the other. It's not something that we want as a surgeon. It's not something that, of course, we want as a patient. But there is a necessity to be patient. As long as there's not any kind of surgical urgency like a hematoma, then we need to wait at least three months to see what the implant position is, and oftentimes some of these subtle differences really will settle out over time.

Either way, if you're ever concerned in the postoperative period, you need to make sure that you call your surgeon and see your surgeon as soon as possible. That's always the most important thing to keep the dialogue open with your doctor. Thanks so much for watching.

Breast Asymmetry Following Surgery Might Be Easily Addressed

Dr. Adam Oppenheimer discusses the fact that no two breasts are alike, both before or after breast augmentation, but if serious asymmetries are lasting long after surgery, there are a few things your doctor can do about it.

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