Asymmetrical breasts after BA. What went wrong? Can it be corrected? (Photo)

Thank you for including your preoperative photograph because as you can see, your breasts and more important your nipple position is starting off asymmetric. Your left nipple areola complex is laterally displaced to begin with and without performing some type of circumaroelar mastopexy, that will not change just with implant placement. Right now, your right side has a higher upper pole than the left side, and without examining you, I cannot say if this is associated with a capsular contracture or not. If your breasts are both soft, then the asymmetry is due to the way the pockets were created and if this has not improved by now, it likely will not without further surgical intervention. I don’t think that anything “went wrong” but possibly poor communication with you and your surgeon regarding ultimate outcomes based on your preop anatomy.

There does appear to be a slight asymmetry before surgery that became magnified after surgery. Small differences in breast size, shape or symmetry become a lot more apparent and obvious with augmentation - the bigger the augmentation the bigger the difference is appreciated. You have a few options depending on your goals. A breast revision surgery may be considered to balance both sides depending on your goals. Hope this helps.

You had slight asymmetry preop and this reveals itself in the postop views. An easy fix would be a periareolar mastopexy on the lower one.

Dear Kayds822,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. Based on your photos, it looks like you would need revision surgery. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Your implants are too large for your chest and the one with the nipple out to the side is pushed too far medically. Your breast bases are not symmetrical to start, so this adds to the problem. I would suggest going down in size and tightening your medial pocket on the side with the outward nipple.

Diverging nipples should be discussed during in person consultations before scheduling surgery. Even mild and divergence will be exemplified with breast augmentation. When the nipple is close to the chest, significant divergence, doesn’t look all that significant because the nipple is close to the chest. With projection did the divergence is made much worse.
When breast are small, and the nipple is close to the chest wall divergence does not look all that obvious. As breast projection is increased with implant augmention the divergence is amplified.
Choosing larger implants only makes the problem more obvious.
The outcome was predictable, based on your preoperative, photos and choice of implants.
If there’s a problem, it is related to a lack of proper disclosure and communication during the consultation.
This is what it looks like when divergent breasts are augmented with large implants.
Understanding your own candidacy, for the procedure is an integral part of maintaining high postoperative patient satisfaction. Patients who don’t understand their own candidacy, for the procedure are more likely to have results that are different than what they anticipated because they were not well informed regarding what each procedure can, or cannot accomplish.
Women who have breast that sit close together, and are pointing forward to more likely to have better augmentation results, than women who have breast that sit far apart or are divergent.
Best,
Mats Hagstrom, MD