I am a 25 years old. Asymmetrical Breasts - Different Shaped Implants for Each Side? (photo)

I am a 25 years old at 5'10.5" and 190 lbs; I have asymmetrical breasts. My surgeon suggested doing a tear shaped silicone expandable implant on my right side in order to evenly stretch my skin / nipple and to do a round silicone implant on my left. I am concerned about having matching shape and feel between the two and am interested in another's view as to if this will even me out in the best way. Also, for the most natural feel I have read that under the muscle is the most beneficial?

Doctor Answers 10

Asymmetrical Breasts - Different #ShapedImplants for Each Side? ANS:

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Im a little nervous about that left (larger) breast. It may have a bit too much droop and end up being too different after augmentation. It would really need an experienced surgeon to see if you might benefit from a little skin envelope tightening, like a donut lift...

Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Correcting breast asymmetry

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Measurements of your body, such as breast width and height, would be required to determine the most suitable implants. You're welcome to see another surgeon for their advice, pending a physical examination.

Subglandular vs submuscular: it really depends on your implants and the skill of your surgeon as to achieve the most natural looking result.


Using two different sized implants.

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It is not uncommon hat surgeons use different sized implants in each breast. The goal is symmetry. When making the decision between a breast lift and a breast lift with augmentation, I look at both the quality of the skin and the amount of breast tissue.  I also look at the position of the nipple.  If the nipple needs to be elevated, then a breast lift will be necessary.  If there is not enough breast tissue, then an augmentation can be performed.  Some surgeons feel that it is safer to do these procedures in 2 separate operations and others perform them together.  Whichever your surgeon prefers, safety should be the primary factor.  The single best way to assess what you need is for you to visit with a plastic surgeon and feel comfortable with their demeanor and their opinion.  Good luck!

Addressing Asymmetrical Breasts

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Thank you for sharing you photos along with your post.

Breast asymmetry is not uncommon; as a matter of fact every patient has a certain level of breast asymmetry - some more noticeable than others.

With that perspective, achieving perfect symmetry is not possible. However, in your case, submuscular gel implants of different sizes is the best way to go about the asymmetry.

Without physical examination, it is not possible to provide you with further details that will enhance your results (e.g. lift, etc.)

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

There are always several options

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Thank you for the question and the photos.  You have several options available.  I think you would be well served by augmentation with different size round silicone implants as well as a purse-string areolaplasty.  Other options would be several sessions of fat grafting followed by a purse-string areolaplasty, and yet a third would be to use an tissue expander implant on the right and then swap it out for implants at a second surgery.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Breast asymmetry

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Thank you for your questions and for providing the photos. Breast asymmetry is very common, and can vary from being quite slight to being extremely noticable and visible in clothes. While it is possible and common to lessen the degree of asymmetry, it is impossible to make the breasts perfectly symmetric. The goal is to make the breasts so close that it is not easily seen.

While your plastic surgeon has the benefit of an examination, I have not found the use of shaped implants to be useful for correction of breast asymmetry, I find it more predictable to use different sized silicone implants and then reshape the breasts as needed. I would be concerned about using different shaped implants creating another aspect of the asymmetry.

As for the most natural feel, I agree that placing the implants beneath the muscle gives the most natural look and feel.

I do think that your breasts can be made to look both better and quite nice. I would suggest discussing your concerns with your plastic surgeon and/or getting multiple opinions to feel comfortable before proceeding.

Best of luck with your breasts.

Jeff Rockmore 

Asymmetrical Breasts

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There is some level of asymmetry with every woman's breasts.  For patients like you I have not used the tear drop implant.  Instead I have had reliable results with using a asymmetric sized saline implants.  I use a a bigger implant on the smaller side and recommend some internal lift dissection on both breasts.  When your breasts have stretched (within a year or so) you can replace the implant easily for a bigger implant if you wish.  Tear drop implants require a very precise pocket dissection and I'm not sure that will produce the most natural result for you.  Best Wishes!!

Concerns about Breast Asymmetry Prior to Breast Augmentation?

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Thank you for the question and photographs.

As you know, some degree of breast asymmetry is quite commonly seen. There may be a variety of different ways of improving your breast symmetry;  nevertheless realistic expectations are important in that absolute symmetry will likely not be achieved.

 I think more important than the exact type of breast implant ( round or shaped) and/or other details of the  surgical procedure will be selection of plastic surgeon. This is where I recommend you spend most of your energy;  do your due diligence and find a well experienced board certified plastic surgeon who can demonstrate significant experience helping patients and your situation. Again, the selection will be far more important than the “details” that one plastic surgeon favors over another…

 In regards to  best “position” of breast implant placement, you will find that there are pros and cons to the placement of breast implants and the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.   

 Again,  in my opinion, most patients benefit from sub muscular ( dual plane) breast implant positioning.

 I hope this helps.

Asymmetrical Breasts - Different Shaped Implants for Each Side?

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Thanks for posting photos. Yes I agree with you better seek MORE in person evaluations from PSs in your city. I would use different sized implants with fat grafting to complete the more even appearance. 

Asymmetrical Breasts

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Assuming that you wish to larger as well as more even, I think the approach is a good one. There is more breast skin on the left than on the right, and considering doing something to stretch the skin and to allow for size adjustment without returning to surgery sounds like a good plan. Getting another in person second opinion is often a good idea, though it may add to the confusion when you get a different approach suggested. 

Thanks for the photo and for the question. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.