My Left Nipple is Enlarged and Right Breast Has Odd Shape? What Can Be Done to Fix These Issues? (photo)

I had my BA + lift about 7 weeks ago to correct assymmetry and sagginess. The implants are silicone overs. 350cc in the right and 250cc in the left. I have several concerns: 1. My R breast has a strange bulge on the side which distorts the overall shape. My doctor recommended to the bulge lipo'd after 6 months. Is this the right course of action in your opinion? 2. My L nipple is extremely puffy/enlarged compared to the R under normal conditions. My dr recommends lipo behind the nipple to fix

Doctor Answers 8

Existing asymmetry

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Thank you for the question. You are still in the post operation recovery stage. It is not uncommon to have asymmetries during this period considering you did have existing asymmetry before operation. It usually takes about 8-12 weeks for the wounds to heal and around 4-6 months for the implants to fully settle. It would be best to visit your board-certified plastic surgeon and get a full assessment for your concerns. Best of luck. Dr. Michael Omidi.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 120 reviews

Contour deformities after augmentation mastopexy.

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Thank you for your questions. You were quite asymmetric before surgery and it is not uncommon to experience some asymmetry postoperatively. At this stage, it is too early to predict correction and more time (2-3 months) should allow for a more predictable revision. The nipple swelling is common after an augmentation mastopexy and typically resolves after 3-6 months.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast implant revisions

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I would wait 2-3 months before making any final judgements on you breasts to allow the implants to settle and for the swelling to resolve.  Then, you might need to have some revisions to address your concerns.

Significant asymmetry seven weeks after breast augmentation will probably require surgical correction.

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The Photographs appear to demonstrate a significant asymmetry of the breasts. I think it is unlikely that this will change much in time. I would guess that you would benefit at some point from a revision.

Breast asymmetry with implant and lift

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First you started out with asymmery and some of the areola difference maybe related to the swelling.  You ultimately may need a revision.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Early breast asymmetry following a breast lift / augmentation

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Well you started out with a fair degree of asymmetry.  There is more sagging on the left side than the right.  The changes that you are seeing post op are not unusual for being 7 weeks post op.  It is hard to tell from your post op picture if there is  significant difference in the height of the nipples from side to side.  There was less sagging on the right side and a larger implant was used this may account for some of the asymmetry.  If things do not change over the next 6 months you may need a  minor revision of the left mastopexy.  I would imaging that the right side will stretch over this period of time and be fine.  I am not sure about liposuction without an exam.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Best Breast Revisionary Operation for Me?

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Thank you for the question and pictures. Given that you are only 7 weeks out of breast surgery, your best course of action at this point is continued patience;  evaluate the end results of the procedure performed several months from now. I ask my patients to wait at least 6 months before considering breast revision surgery,  in most cases.

What, if anything, will be necessary to improve your situation will be based on your physical examination and specific goals. Liposuction surgery may be helpful if the contour issue is related to adipose tissue, on the other hand, if the contour “problem” is related to breast implant or tissue, liposuction surgery may not be effective and may cause harm.

 If you have concerns about your plastic surgeon's recommendations, your only good recourse would be to seek a second opinion consultations with well experienced board-certified plastic surgeons in your area.  Online consultants, without the benefit of direct physical examination, will not be able to provide you with precise/specific enough advice.

 Again, at this point, your best friends are patience and time.

 Best wishes.

What Can Be Done to Fix These Issues?

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Thank  you for your question and for the posted photos. The postop photos would be more helpful if posed the same as the pre-op, with the arms at the sides (the standard view), because elevating the arms pulls on the breast tissue and makes it less than helpful for comparison. 

I would recommend patience. The right side seems to have some scar retraction of the vertical scar, and sometimes those improve with time and massage. Swelling in the areola is not uncommon, and usually resolves. I can't tell whether this has been decreasing or not over the 7 weeks since recovery. 

\Expect for  problems of hematoma, seroma, or infection, it is generally unwise to think about revision surgery before 3-6 months. That would be the time to consider the alternatives. 

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.