Hi and thank you for the question. Almost every person has some degree of asymmetry in their breasts related to size, shape, nipple position or fold position. Based on the photos you provided you appear to have developed breast tissue on both sides, but one breast has more volume. When you say one breast was/is filled with fluid: there are different reasons why that might happen for patients having surgery vs patients who have not had surgery. For someone who has not had surgery you could have fluid filled cysts. That would be diagnosed most commonly using an ultrasound. Before you pursue possible breast surgery to address the asymmetry you should discuss the fluid issue with your OB-gyn or whatever doctor (family doc/internist) you see annually. They can do an exam and/or refer you for breast imaging or evaluation by a breast specialist. From a plastic surgery point of view: you can address the asymmetry with implants or fat transfer. There are pros and cons to both. I would suggest seeing a board certified plastic surgeon to go over your concerns and discuss your surgical options. Best of luck to you.
Dr West
Hi and thank you for the question. Based on the photos you provided you appear to have constricted, but not tuberous breasts. Tuberous breasts involve a constriction, which you have, but also involve breast tissue that pushes out through the nipple/areola complex. This gives a puffy appearance that you don't see in your photos. Constricted breasts are most commonly made more symmetric using implants and a lift, but fat grafting with our without a lift is an option. One of the challenges in your case is that you have a smaller skin envelope on your smaller breast. So while is the side that needs more fat, it's overall capacity to take on new fat is less than the right side. An issue we have with all fat grafting cases is that some of the fat inevitably dies. So we often see patients who are happy with their one week results when the breasts are swollen from surgery and all the fat is present, but are then unhappy at 3 months when the swelling has resolved and 20-40% of the fat has disappeared. That being said, it is a very reasonable option as long as you understand you may require a second or possibly 3rd (depending on your overall volume goals and how much fat lives). Best of luck to you.
Dr West
Hi and thank you for the question. Breast size is extremely variable. You have breast tissue which puts you within the normal range. In terms of shape, you do appear to have constricted breasts. That means that the lower part of your breasts did not develop as fully as some other patients. It is very common. You do not appear to have tuberous breasts. This is similar to constricted breasts but breasts a puffy look because the breast tissue pushes outward through the areola. We perform breast surgery on a regular basis for patients with constricted breasts. In most cases we place implants and perform a mastopexy (breast lift). The lift elevates the nipples/areolas to a more central position on the breast (and we can reduce the areola size at the same time). Best of luck to you.
Dr West
Hi and thank you for the question. I'm sorry you weren't able to achieve your goals with the first two procedures. Photos can only show us so much, especially when we don't have the type of lighting that we typically use for office photos. Is your concern a shape or volume asymmetry? Shape can be modified to some degree by opening or closing the pockets. Volume can be addressed by changing out either the larger or smaller implant. With regards to the gap. Again, it's difficult to judge because the lighting and scale of your photos aren't the same. But what you can see is that your nipples are already oriented out to the side of your breasts - like most patients, your nipples are not located right down the middle of your breasts. Right now the look is pretty normal. However, one consequence of closing the gap between your breasts is that as the implants move closer to the middle, your nipples can start to look like they are pointing out to the side. To avoid this, you can use even larger implants so that you get volume both in the middle as well as out to the side to maintain a reasonable nipple position. The other asymmetry you can address is the difference in nipple/areola height. You could do a one sided breast lift to make them more symmetric. Overall I think your results are pretty reasonable, but you could make some adjustments that might make you more happy. Best of luck to you.
Dr West
Hi and thank you for the question. I'm sorry that you haven't been able to achieve your goals after having so many procedures. The photos you provided give some insight, but don't tell the whole story. Seeing other views and knowing exactly what other procedures you have are important for dispensing advice. Because of the complexity of a case like yours in which multiple surgeries have been performed, the best thing for you do to is to schedule several consultations with board certified plastic surgeons who focus on breast surgery. And preferably those who perform a high volume of revision breast surgery. I can't speak to your specific case without more information, but there are usually options to improve outcomes. You might need to start with implant removal only, or removal and revision of your mastopexy. Once you have established a good breast shape with better scars, you might be able to place new implants. This is just a general idea of what might work. Again, you really need to see some high quality plastic surgeons in person to get good advice for this. Best of luck to you.
Dr West