Breast augmentation and chest wall asymmetry
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
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.
Obtaining symmetry after Breast Augmentation
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.
Management of breast asymmetry
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.
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.
Breast Augmentation for asymmetrical chest wall and nipples
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
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.
Pictures and examination needed
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.
Breast implants should make breast asymmetry better.
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.
Improving asymmetry with breast implants
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.