Breast Augmentation for Patient with Asymmetrical Chest Wall and Nipples?

Hi. I am booked in for a Breast Augmentation, however, when I had my consultation, I was told I have one breast bigger than the other, one nipple higher than the other and also a difference in my chest wall. My left is more prominent than my right.

My surgeon told me that he wouldn't be able to give me the perfect breasts I would like and the Breast Augmentation will exaggerate my asymmetry, making it look worse and due to the difference in my chest wall, it will cause the implant to sit differently. I don't know what to do?

Doctor Answers 10

Breast augmentation and chest wall asymmetry

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It is true that if your chest wall is asymmetrical and the nipples are at different heights, an augmentation potentially will magnify these issues rather than hiding them. However, a very experienced plastic surgeon can get around this somewhat and lift the lower nipple and use different size implants to accomodate the chest wall issues. Don't expect perfection but an experienced surgeon should be able to give you a nice improvement.

Breast Augmentation with Asymmetry of Chest Wall and Nipples

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In general, every female has at least 5 types of minor asymmetries of the breast, chest wall, or nipples. That is a normal variation. These will not be resolved entirely by breast augmentation alone. Not infrequently, it may require different type of asymmetrical breast tissue release or even different size implants. These all require that you have a procedure done by a board certified plastic surgeon that has expertise in breast augmentation and has assessed your chest wall asymmetries pre-op. On the surface, breast augmentation may appear to be simple, but it can be quite complicated especially in patients who have an asymmetric chest wall and nipples as well as constricted base dimensions.  These are key to assess pre-op to acquire the best result post-op. One can never accomplish total symmetry.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Obtaining symmetry after Breast Augmentation

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Please look at your face and body carefully. You will notice your face and body is not perfectly symmetrical. No one has perfect symmetry.

If God and or 5 billion years of evolution could not achieve perfection in our bodies, it is impossible to expect such a result from your plastic surgeon.

Having said that, I have operated on several patients with chest asymmetry. Did I obtain perfect symmetry? No. However, they look much better than before surgery, and are much happier.

I commend your surgeon for being honest with you. But also look at his/her before and after photos and see if you like the work. The good thing with the internet is you can compare before and after photos of several doctors.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Management of breast asymmetry

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There are many different options and th correction depends on the problem encountered. I have prepared a video presentation on this you may want to review. I am attaching the link below.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast Asymmetry

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Most breasts have some asymmetries. And most are not identical to the other. We generally point out these issues because most patients done realize the differences they have between each breasts. And what happens afterwards is that the mirror and your breasts become very familiar with each other and you may notice some of the asymmetries. So we point these things out so that the patient is aware before the surgery.

Breast implants if done correctly can greatly help improve in the significant breast asymmetries.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Breast Augmentation for asymmetrical chest wall and nipples

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My initial impression from your posting is, you have a very honest and careful surgeon. But if this honesty concerns you than by all means obtain additional evaluations. Yes, most of us, plastic surgeons, will attempt to "adjust" the asymmetry via differing implant sizes, or a implants, or areolar highering. My point is make sure you understand what is being done, informed consent. Regards.

Breasts worse after augmentation

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I think your surgeon is right in pointing out the asymmetry of your breasts before surgery, to caution you that your postoperative result may accentuate what he already pointed out to you. This is giving you an honest asessement of pre- and postoperative appearance of your breasts,

Having said that an experienced surgeon can correct some of those "imperfections" with the choice of implants, implant size, alteration of nipple/areola etc.

It is rare to find a woman with "perfectly symmetric" breasts. We always strive to work toward that (elusive) goal!

If you are otherwise comfortable with your surgeon, go ahead and than enjoy.

Good luck.

Guido P. Gutter, MD
Evansville Plastic Surgeon
4.9 out of 5 stars 18 reviews

Pictures and examination needed

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Without examination and seeing pictures, it is hard to give any recommendations. Correction of the breast, chest wall and size aymmetry with implant is hard and some times impossible. If your plastic surgeon does not feel comfortable to do your surgery, he is an honest surgeon and he knows his and your body's limitation.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Breast implants should make breast asymmetry better.

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Get another opinion.  Breast implants should make you look better!  Different sized implants can be used in each breast.  Sometimes a little breast lift on one side can also imptove symmetry.  The folds under the breasts can be adjusted.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Improving asymmetry with breast implants

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There is a surprising amount of debate about the best way to deal with breast asymmetry. One camp is that the breast and chest are asymmetrical to begin with, and they won't be perfectly symmetrical after surgery, so it should just be accepted. I am in the opposite camp, in that I believe we should do what we can to improve the situation, even though perfect symmetry in not acheivable.

One technique that I have found very useful in these cases is the use of expander implants (Mentor Spectrum.) These are saline implants with a fill port that is placed under the skin near the implant. The implants are only partially filled when they go in, and volume added later over a period of a couple of months. This allows for fine-tuning the volumes so the match is better. Once the final volumes are selected, the ports are removed (usually under local anesthesia) but there is the option of an additional procedure to reposition the nipple-areola at that time as well.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

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.