Is It Normal for One Breast To Swell More than the Other After Breast Augmentation?

I had breast augmentation 4 days ago, I was originally a 34B / 36A. I chose 450 CC implants for the surgery. Looking at my breast now it appears one is larger then the other- is it normal for one to swell more then the other? if you had to guess, what size do you predict I will be once all swelling is gone and do you think my breasts will even out in size?

Doctor Answers 20

Healing after breast augmentation

the two breasts frequently swell differently.  if they were symmetric before and the same size implant was used. they will have equal volume after they heal


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Normal for one breast to swell more than the other after BA

It can be totally normal. were your breasts the same size before the surgery, were the same size implants used. It is not uncommon for the dominant hand side to seem bigger due to the thickness of the muscle, and the muscle not "liking it". I would return to your surgeon and ask their input and advice.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 20 reviews

Breast implant asymmetry/size after augmentation?

Thank you for the question.

Some degree of asymmetry is a common 4 days after breast surgery. Unfortunately there is no way to know what cup size you will end up filling.

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.


2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.


4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

 

Swelling

Thank you for your question. Swelling more on one side than the other is normal as long as the swollen side isn't purple and extremely painful. It seems many patients on this site have the same question. If you wait of the implants to settle and for the skin and muscle to round-out around the implants, you can expect to have a very nice result. This may take up to a year.

Swelling After Breast Augmentation

Thank you for your question. I have included some typical expectations of breast surgery recovery and signs to watch for following breast augmentation:

  • Stiffness, swelling and bruising in the chest region: These are normal experiences as the skin, muscles and tissue heal. Pain medication and muscle relaxants will help you cope with any discomfort. Consistent sharp pain should be reported to your board-certified surgeon.
  • Hypersensitivity of nipples or lack of sensitivity: This is normal and will gradually resolve over time.
  • A mild to severe itchy feeling of the breasts is possible as healing progresses. An antihistamine like Benadryl can help to alleviate severe, constant itchiness. If the skin becomes red and hot to the touch, contact your board-certified surgeon immediately.
  • Asymmetry, the breasts look different, or heal differently: Breasts may look or feel quite different from one another in the days following surgery. This is normal. No two breasts in nature or following surgery are perfectly symmetrical.
  • Discuss returning to work with your board-certified surgeon, in our office it is typically 3-5 days post-surgery but you may not overexert yourself or do any heavy lifting.
  • You may resume exercise and your normal routine at six weeks unless your surgeon advises otherwise.
Every patient heals differently and each breast heals at its own rate. This seems perfectly normal. If you have any concerns regarding your recovery, please follow up with your board-certified surgeon. 

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 52 reviews

Post-Operative Breast Asymmetry

It's not unusual for patients to note breast asymmetry immediately following breast augmentation surgery. This asymmetry can occur for a variety of reasons, but is often related to swelling which takes time to resolve. It usually takes about 4 to 6 weeks for enough swelling to resolve to make aesthetic judgements possible. In your case, it's virtually impossible to make a recommendation without a picture or physical examination.



At three months, the majority of patients are happy with their symmetry and aesthetic result. It's, therefore, important to be patient in the immediate port-operative period. It's also important to discuss these issues with your plastic surgeon. Your surgeon can rule out more serious problems such as hematoma formation, implant migration and other causes of post-operative asymmetry. Hopefully, he can alleviate your anxiety and ultimately make this a better experience for you. Unfortunately, in this case, there's not enough information to make an estimate of your final breast size.

One breast has more swelling

Thank you for your question.
It is quite common during the healing process for one breast to have more swelling. As you continue to heal the breasts swelling will subside and you should have a nice result. Continue to follow you surgoens instructions and follow up with him or her with any concerns. Best of luck.

Swelling after breast augmentation

Thank you for your question. Congrats on the surgery. It may take months for the breasts to soften and settle, and they may never soften to the pre-surgical state. In addition, the greater the implant to breast tissue ratio, the more the implant will affect the longterm firmness (or softness) of the breast.  It is also normal for one breast to soften before the other.  I would exercise patience and see how things change with every few weeks that pass by.  I would continue to follow up with your surgeon closely during the healing process.

Asymmetrical swelling common after breast augmentation

It is very common for one breast to be affected by swelling or than the other. Swelling usually subsides within a few weeks after surgery. While it is difficult to say what size you will actually be after the swelling subsides you will most likely be around the size you wanted to be since the implants were selected for that purpose. 

Implant differences

All breasts are a bit asymmetric.  At 4 days it is very hard to tell what the final shape will be. Unless there is a huge difference, with pain, and bruising, it is more likley routine post-op swelling.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.