I Had BA 4 Months Ago with 400cc High Profile Silicone Smooth Implants, And They're Uneven and Cause Pain. Cause? (photo)

I Had Breast Augmentation 4 Months Ago with 400cc High Profile Silicone Smooth Implants and they look very uneven and the left breast looks much bigger than the right. This was my third augmentation in 13 years. This is the first time with silicone. I had saline implants previously and had a left deflation after 7 years. They all have been placed under the muscle. I am also having intermittent pain in the left breast as well. Can anyone tell me what happened that has caused this mishape? I don't know if they migrated out of the pocket or what.

Doctor Answers 12

Asymmetric breast implant revision

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We can clearly see the fullness on one side. The pockets are uneven and it is hard to know why things are the way they are without knowing how it all started out. If the breasts were even before revision we can suspect things like a seroma or bleeding, which can explain the tenderness. Nothing migrated, and without more information your surgeon will have a better idea of what has gone on.

Best of luck, peterejohnsonmd.com

Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Augmentation asymmetry and fold discrepancy.

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Thank you for your question. The implants are certainly in different positions on your chest wall. This can represent one of several situations:

  • Your folds were uneven to begin with
  • The left breast fold has lowered or "bottomed out"
  • The right breast implant is sitting too high or has a capsular contracture
  • A combination of the above issues

To determine which of the above issues has occurred, preoperative photos are necessary as well as an exam. The left breast pain can indicate that the implant is bottoming out. Size discrepancy often is related to the pocket shape and how it holds the implant, particularly if you were symmetric before. Recommendation is to bring your concerns to your plastic surgeon. If they cannot help you, find another Board Certified Plastic Surgeon to see.

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

I Had BA 4 Months Ago with 400cc High Profile Silicone Smooth Implants, And They're Uneven and Cause Pain. Cause? (photo)

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Thanks for the posted photos. Very hard to determine the reason of the distortion. Before photo might help. Best to obtain in person second opinions. 

Breast asymmetry

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Most likely, the saline implants were filled differently to balance the two breasts, but placing the same size silicone implants "unroofed" the asymemtry. You probaably will need a larger implant on the smaller side when things settle down.  Of ocurse an exam is key to evaluate the two breasts.

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

Asymmetry after BA

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My guess is that you always had some significant asymmetry. The problem could be worse because it was not realized before surgery. Your saline implants could have been filled to different volumes that the new surgeon did not know about. Because the same size gel implants were used it uncovered your underlying asymmetry. Of course all of this assumes that you used a different surgeon. If it was the same surgeon, and you were more even before surgery, than it has to be a technique issue, something that your surgeon should be able to explain since he/she was there.

Post-op Asymmetry

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As everyone has told you, pictures are helpful but don't replace an in-person exam. Based on the photos, you right breast looks fine and if it feels soft then that is the good one. Your left breast, as you know is much bigger and the skin of the lower breast appears to be stretched beyond normal. If your breast were close to the same size before your surgery, I can only think of two causes: either the left side has a bigger implant or there is a fluid collection (seroma) surrounding the implant. Either way it needs to be corrected so get back to your plastic surgeon.


Joseph Fata, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 105 reviews

Breast Augmentation Beverly Hills

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It looks like you have some level of capsular contracture to the right breast. Does the right breast feel stiffer than the left? Usually the breast that is lower will appear larger than the breast that is higher. The pocket is wherever the implant sits. Saying the implant has migrated out of the pocket doesn't really make sense. But pockets can shift in their location. Your pocket on the right side is higher and would need to be lowered and possibly the left side elevated a little for greater symmetry.

David E. Kim, MD
Beverly Hills Plastic Surgeon
4.6 out of 5 stars 106 reviews

You may have capsular contracture

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The pictures are helpful but does not replace consultation. I would suggest going back to your surgeon for further evaluation. You may have capsular contracture and bottoming out of the left implant.The original pictures before augmentation would have been helpful to evaluate for asymmetry.

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

Hard to know exactly

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were the implants more symmetric immediately after surgery?  or has the asymmetry persisted since surgery.  were the same size implants used?  for one, you have some nipple asymmetry which is just a part of you which has persisted after surgery.  It is possible that you have a capsular contracture which has elevated your right implant.  i suggest you return to your surgeon for consultation or see another board certified plastic surgeon if you are not happy going back.

Eric Chang, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast Asymmetry and Pain after Breast Augmentation?

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Thank you for the question and picture.

It is very difficult to give you good advice without direct examination.  Examination would be necessary to make an accurate diagnosis and develop a treatment plan. Assuming your surgeon is a well experienced board-certified plastic surgeon he/she is in the best position to do so.

Based on your picture however,  the significant breast asymmetry you describe is visible.  Your symptoms may be related to implant  displacement on the left side.  For example, if the implant is displaced in fairly or laterally,  it can cause pressure like symptoms/pain in those areas. Sometimes, when a breast implant displaces inferiorly,  the entire breast appears to be larger in size. Your theory that the implant may have “migrated out of the pocket” may be accurate.  Again, this can best be diagnosed on physical examination after determining where your “intermittent pain” occurs.

Sometimes, early breast implant encapsulation may cause intermittent pain;  again this will be best diagnosed on physical examination.

The good news in your situation,  is that if the breast asymmetry does not improve ( given that you are only 4 months out of your last operation),  improvement can be achieved with revisionary surgery.

I hope this helps.

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.