I have seen and treated a number of patients with striking asymmetry such as you exhibit. Simply trying to put offsetting size implants in is not going to give you an optimal result. My recommendation is to usually do a breast reduction on the larger breast to get the best symmetry possible with the smaller side. Then after allowing for tissue swelling and edema to subside for three months or more go in and put in the desired implant. You really need the skin envelopes to be roughly equal before your implants are placed to get a nice symmetry.
I hope this has been helpful.
Robert D. Wilcox, MD
Based on your photos different sized implants will solve your asymmetry.You do not need any lifting procedure. Please consult with a board certified plastic surgeon. Good luck...
Thank you for the photos. Breast implants will help with your size asymmetry, and using two different-sized implants is probably the way to go. A periareolar lift on the right side will help to even the height of your nipple/areolar complexes. My suggestion would be to try on implants in your PS's office to decide which style and size of implants will give you the result to make you happy. Different lift approaches could also be considered to give you the least amount of scarring. I hope this helps. Best of luck!
Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a Breast Augmentation
Having some degree of breast asymmetry is very common. Achieving mirror-image symmetry after surgery is not realistically possible. Selecting differently sized implants will certainly go a long way in helping to achieve breast volume symmetry, but you may still want to address the differences in shape and nipple/areolar position. In order to lift the droopier right side, you would be accepting the scars associated with a breast lift; in your case, that will mean a scar around the right areola and possibly a vertical scar along the bottom half of your breast. Your right areola could also be reduced in size a bit to more closely match the diameter of the left side. Unfortunately, doing a lift on one side introduces another asymmetry in and of itself. One question to answer would be if you would rather have symmetric nipple/areolar position with a scar OR asymmetric positioning without the associated scars. There is not a right or wrong answer, but, in general, the more significant the asymmetry or droop, the easier it is to accept the scars related to a breast lift. Best of Luck!
I would recommend going with the different size implants, and allow a year for final stretching. After that if the difference in nipple heights is noticeable, then raise the lower nipple.Good luck.
Judging from what I can see in the limited anterior view of your breasts, it appears that you have significant asymmetry in size (which can be addressed and made more symmetric with different size implants) as well as shape (in your case a right breast that has more glandular ptosis (natural hang) and and a left breast that has some constriction of the lower pole as well as a short nipple to inframammary fold distance). For the second problem I think the best option is to do a lift for the right breast (as well as using a larger implant for the left). Whether you can get by with a peri- areolar lift or need a vertical/ lollipop scar lift is a judgement call that your surgeon has to make based on his ability to examine you thoroughly in person and sometimes based on how it looks on the operating table. I would also take into consideration what your goals and expectations are as far as what's more important to you (having less scars or having better symmetry). Your case is a challenging one. I would recommend that you see several board certified plastic surgeons who have a lot of experience doing breast lifts and correcting severe breast asymmetry. Best wishes.
Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) : Breast Augmentation.
I recommend you to use microtexturized highly cohesive silicone implant ("gummy bear" implants), with high projection, and 550ml will be excellent on you, to fill the breasts properly.
Dr. Emmanuel Mallol Cotes.-
You appear to have the right side larger and with droop. To correct this so both are symmetric and as close to each other as possible requires using different sized implants and a lift on the right (I would not do a reduction on the right). This will result in a vertical scar on the right which extends around the areola. If you are not worried about the droop, you could do just the asymmetric implants. However, if you use silicone implants (which I highly recommend) the scarring is as great as with the implant and lift since you need an inframammary incision in both breasts to reduce the risk of late implant rupture and the periareolar incision almost totally disappears. (On the right, the implant could be placed safely through the reduction incision.) I hope this helps.
You are correct, in that you have multiple options here. An in person exam and full discussion with a surgeon will help you make the best decision. In my opinion, your asymmetry is not too terrible. I've certainly seen much worse. I would consider starting with a dual plane lift, placing the implants under the muscle on both sides. On the left side, you need to increase the distance from the nipple to the breast fold below. I would use implants with only small difference between them in volume, and more projection on the left. Wait 6 months to let them drop and stretch the left breast, then evaluate. If not that asymmetric you are done; if the right is still fuller or lower you could then elect to have an appropriate lift and/or reduction.