Breast Augmentation and Asymmetries, How does the Surgeon Decide the Difference in CCs? (photo)

I'm wondering how a plastic surgeon determines the amount of difference in CC's needed to attempt to even out asymmetries. My surgeon has decided that 25 CC's more in my smaller breast than my larger will help correct mine but I'm just not sure how he arrived at that amount and my untrained eye compared 25 CC's of rice to 50 and it seems to me like 50 CC's would actually come closer but then I suppose you have to take into account the difference in width of the implant as well?

Doctor Answers 13


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I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.

Best wishes,
Dr. Basu
Houston, TX

Breast Augmentation and Asymmetries

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It is quite difficult to completely correct any type of breast asymmetry as every female has some degree of breast asymmetry whether it is in the nipple, in the breast mound or the fold.  In general, less than 50cc is not recognizable in most patients unless the patient has a small frame or almost no breast volume.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Determining implant sizes in asymmetrical cases.

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There are a combination of approaches which I use to determine implant sizing for augmentation which allow for accurate appraisal in asymmetric cases. I begin with a detailed measurement of the breast anatomy to bracket a selection of implant which will fit the breast. We then use a sizing system which allows a patient to place varying sized implants into her own bra and see what different sizes will achieve. Once the narrow range of implants have been decided, I use sizers in the operating room to fine tune the implants to determine differentials. While under anesthesia, the patient is sat upright and the sizers are trialed until the most symmetric match is made. This makes it much easier when deciding if a 50cc or 75cc size difference is needed. Most plastic surgeons will approach asymmetric cases in this stepwise fashion.

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

Breast Augmentation with Asymmetries

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Actually almost all women have asymmetries of their breasts. No two breasts are identical and that should be noted in all breast surgeries before the opertation because there is often some slight asymmetry after the surgery as well. With augementation of the breasts with saline implants, they may be filled to different amounts to correct the differences in the breasts. Silicone implants, when used, may require different sizes to make the breasts more similar. In rare case breast tissue may be removed or reshaped to create a closer macth. An experienced Board Certified Plastic Surgeon will discuss your different options.

Sheila Bond, MD
Montclair Plastic Surgeon
4.4 out of 5 stars 40 reviews

Asymmetry of breasts

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ASymmetry is common in all breasts. AS for implants, difference can be visualized and palpated and tested in the OR with sizers.

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

Breast Asymmetry Correction With Implants

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    Dear Bravenewtina,     Almost all women have some degree of asymmetry with their breasts. There are multiple ways to address this issue including: different sized implants, various breast lift techniques and removal of tissue from one or both of the breasts. In your case it appears that a larger implant in your smaller breast should do the trick.  As my colleagues have mentioned, different surgeons use different ways to determine volume differences. We use intra-operative sizers and years of surgical experience to determine the differences. The other thing to consider is that silicone implants only come in 25cc or 50cc increments, while saline implants can be adjusted to the 1cc increment. That being said, it is very difficult if not impossible for the naked eye to see differences smaller than 10-15cc in my opinion.  Express your concerns with your surgeon and have him/her explain to you why they think 25cc is appropriate for you. Judging from your photos, you should have a great result.



Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
4.8 out of 5 stars 178 reviews

Creating Breast Symmetry with Implants

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Creating perfectly symmetrical Breasts utilizing implants if a very difficult proposition. Remember,your breats are sisters not twins, and they will never be perfectly symmetrical. There are multiple techniques out there, 3-D imaging, pre-operative sizing with implants, intra-operative sizing and just simply using the trained eye. Discuss your concerns with your board certified plastic surgeon and I am sure he will discuss how he came to that conclusion and listen to your input. 

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Deciding the difference in breast asymmetry

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Perhaps your surgeon was only making a guess at the 25cc, and you may be right with a difference closer to 50cc. Correcting breast asymmetry can be a difficult process, and we prefer to use a breast sizer in the OR to try things out before making the final call.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Correcting breast as asymmetry

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There are  a few ways to help determine the difference in breast volumes. One is to use the rice method, which has been the traditional gold standard.  This should give a very accurate estimate of the volume difference between the two breast.  There is now available sophisticated 3D. Imaging software that will also give a very accurate estimate of the volume difference.  This may be the most accurate method.  Finally, the surgeon can use intraopertive sizers during the surgery to confirm the correct size implants to be used.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 46 reviews

Breast asymmetries and breast augmentation

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I often tell patients that a difference of 25 cc is barely visible and that if I notice a difference the difference is at least 50 cc.  I do not use the 3-D imaging systems but those have their own issues.  The important thing is that at surgery I use sizers (temporary implants) to help establish symmetry, and it is all done using my judgement and experience.  Your surgeon has her/his own way I am sure, but sizers help me.    I hope you are seeing a board certified plastic surgeon.   BTW, based on the photo I would recommend you do a breast lift, more so on the left than the right. Best of luck.

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.