Mastectomy 12/22 with immediate reconstruction. Since day one with expanders left was larger than right?

Hi guys - masecto 12/22 with immediate reconstruction. Since day one with expanders left was larger than right. PS said they'll even once implants go in. 7/18/16 exchange surgery occurred. Put 650's on both side, but left is so much larger?? Why is this? PS said it was s collapsed muscle and I have to deal, I don't feel I should settle. Had I known there'd be such a visible difference in size, I would not have chosen reconstruction.

Doctor Answers 3

Breast reconstruction

Not sure what happened for you, but when I do this procedure if one side appears larger during expansion with equal amounts of fluid, then I try to adjust the volume with the expanders before exchanging to implants.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast Reconstruction Asymmetry

I am sorry to hear that you are asymmetric following your bilateral breast reconstruction following your bilateral mastectomies. Depending on your situation you may be asymmetric for a variety of reasons. Many times the breast with the cancer is often times smaller because the breast surgeon removed more tissue and left a thinner flap on the breast cancer side versus the prophylactic side. Depending on the variation of the skin flaps- this can sometimes be the reason that the two breasts are different. Also if one of the sides was previously radiated or one side was radiated while the expanders were in place- this can also account for the asymmetry. Many times placing different size implants can help correct this asymmetry. Often times, fat grafting can also be used to help correct small asymmetries among the two sides. I recommend that you meet with your breast surgeon and see what else can be done to help with symmetry amongst the two sides. It is common to sometimes require a touch-up surgery even after your permanent implants were placed- so do not be upset by this.

Good Luck to you!

Helen Perakis, MD
Nanuet Plastic Surgeon

Size discrepancy after reconstruction

Hi there.  I'm sorry you are left feeling lopsided.  I have had several incidences where this issue came up.  Sometimes when women undergo a bilateral mastectomy, one side is for cancer and one side is prophylactic.  One of the breast surgeons I work with routinely leaves a somewhat thicker skin envelope on the prophylactic side than the cancer side.  This would cause you to appear asymmetric with the same implant in both sides.  Another possible cause is if you have had radiation therapy on one side.  That may cause your tissues to shrink and tighten, appearing smaller than the unradiated side.  Regardless of the reason, talk to your plastic surgeon about evening you up.  Many patients require a larger implant on a side that has been radiated, or a smaller implant on the side that had a less aggressive mastectomy.  The important thing is that you look and feel your best - not that the numbers on your implants match.  If you don't feel your plastic surgeon can help you with this, I recommend you find another who can!  You are right that you shouldn't accept a reconstruction that doesn't make you feel your best.  Good luck and feel free to reach out to me if I can help!

Dr. Jespersen

M. Renee Jespersen, MD
Arlington Plastic Surgeon
5.0 out of 5 stars 4 reviews

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