After Breast Augmentation, One Breast is Larger Than the Other?! Please Advise. (photo)

Thank you for your question and for sharing your photos. During the post-operative period the breast are swollen, and the breast implants appear in a much higher position. Over time they descend and fills out the lower half of the breast. In addition, it is not uncommon for one breast to be more swollen than the other and may even out with time (unless they were asymmetric in size to begin with). It may take several months for this to happen and can be encouraged with breast massage and compression. It may appear that the breast enlarges as the lower aspect of the breast fills out (at the expense of the upper portion of the breast).  From the pre-op photo, there is a slight shape/size difference which has carried through with the breast augmentation surgery.  I would wait a few months and revisit with your plastic surgeon to discuss your concerns.

Thank you for your pictures.  I think your result is very good. Most women have some asymmetry.  I think you will only be pushing your luck trying to achieve perfection.

Dr. ES

Your pre-op photos show that your breasts were very different before surgery. One is smaller and more narrow. The other is larger and more round. Often implants can make these differences more noticeable. Sometimes they can be made to look closer alike but generally there will still be some differences. Ideally these things are discussed during the consultations before surgery. I don't think that the type of implant, saline or silicone gel, would make any difference.

From your pre-op photo, you appear to have started off with some asymmetry with your left breast being smaller and a different shape.  When you have a breast augmentation, I always mention that irregularities of the breast are more visible.  Remember, no one is perfectly symmetrical.  2 months is still too early to worry about this being your final result, so try to give it another couple of months and re-evaluate then with your surgeon.  Continue to follow up so your progress can be tracked with photos and should you decide you want a revision, you can go over your options then. ac

Thank you for your question. I hope this helps you. So, many things may or may not be discussed prior to surgery. Every surgeon has a different way of going about a consultation. There is no standard. I personally point out every single asymmetry I see at the consultation. The reason I do this is because sometimes there are asymmetries that can be fixed and sometimes it is not worth fixing because of the potential negatives. I point asymmetry out because most women are NOT symmetric to begin with. And, when you have your breasts augmented you also augment a subtle asymmetry into something that may be more noticeable. If you know this up front then it is no surprise after surgery if and when it happens. You seem to have a beautiful augmentation with implants that are still sitting a little high and will settle over time. If one is a little bigger then that is something that you have to decide, were you like that before surgery or not??? If you were, well then this was expected. One can never predict exactly what an implant is going to look like once it is placed. I have had patients that I thought would take one size and then end with with an implant very different from what I thought, and I have had ones that are exactly what I felt the implant would be for them. To my eye in your picture you clearly have a larger right breast. I feel that your breasts have different shapes overall, and if you were my patient I would tell you to expect that after surgery as well. I can correct some of the size discrepancy with different size implants if needed, but the shapes I can not get to look exactly the same. I joke all the time that your breasts will be sisters, not twins. I think if you are patient and give your implants many more months, your skin will loosen, the implants will drop, and you may feel very different about your result. If down the road you are still unhappy and feel things need to be changed. Well, then you go have a very nice easy conversation with your surgeon about the things you would like to see different. Then they will be able to tell you if they are realistically able to produce that result or not. There are so many personalities in surgery such that if you come off accusing a surgeon of causing something, they may clamp down and go into defense mode and not feel like they can help, but if you point out things you wish you could see different, well maybe that same person may say, hmmmmm I don't see what you see and I can't fix that or, I totally see what you don't see now let's do something about it. Give yourself a good 6 months here to see how things settle. 

Commonly breasts are different sizes before surgery and unless implants of different volumes are used then they will stay that way.

My feeling on the post op asymmetry of your breasts is in order: 1. wrong sizes used, 2. possible hematoma/seroma, 3. combination of 1/2. The only way to correct is additional surfer. Either new ;larger implant or fat grafts or both. 

You have some degree of pre-existing symmetry issues.  The right breast appears to be larger and the left breast more narrow.  It is important to understand what can and can not be corrected with implants.  It is possible that a larger implant on the left could make a difference for you.  At this point I would give it another 2 - 3 months before considering a revision.  

Your breasts were fairly different shapes and size preoperatively based on the photo.  The right breast appears larger, rounder and flatter across the bottom.  The left breast appears narrower and pointier versus the right side.  Thus, using the same size implants will leave you with some asymmetry, like you had preoperatively.  From the post op photos, it appears the the right implant may be sitting to high, but this is hard to tell for sure from your pictures with your arms up.  Ideally, it would have been nice for you and your surgeon to have discussed the differences in your breasts preoperatively.  

To properly review photos, the arms should be at the sides. With arm elevation, the breasts change (both before and after surgery). The breasts looks slightly different before and after surgery, and no one is completely symmetric.

I assume, but am not sure these were taken in the mirror, and I am not necessarily sure which is the larger size. 

Without seeing a preop with arms at the sides, it is hard to comment on the outcome. Best wishes.