One Breast Bigger Than the Other? (photo)

Question

hello, so i had my surgery april 11th, which is almost 3 months ago. It looks like they have dropped, but one is dropped way lower then the other. I LOVE my results except for that fact :(, and im very upset. The right one seems to have more upper pole fullness while the other one seems to have a lot less. I went from 34 a , and got 425cc silicone, high profile. i keep having this fear that maybe the implant ruptured on my right side.Please tell me what could be going on. Thank you so much.

Richard H. Tholen, MD, FACS · Answer

At 3 months post-op, most of your surgical swelling should be resolved, and softening and settling of the implants in each of their pockets should have occurred. Your asymmetry is quite visible (not minimal), and you have every right to question your surgeon about what may be going on. Schedule an appointment, and ask to review your pre-op photos with your surgeon.

	Pre-existing asymmetry may be part of the explanation, but your present appearance may also be due to pocket creation differences, inadequate or incomplete muscle release on one side, bleeding or fluid on one (the larger) side, or even early capsular contracture. A single photo on the web does not replace an in-person evaluation by your surgeon, or one of several ABPS-certified plastic surgeons who would be happy to give a second opinion, if your own surgeon is unwilling to do so.

	BTW, implant rupture is so unlikely that I didn't even include it in the list of possibilities for your asymmetry. I am unsure why you are worried about this; the present generation of silicone gel implants are cohesive and cannot leak. Rupture is theoretically possible and I have seen it 3 times in over thousands of patients with present-gen implants, but unless you survived a head-on collision where your breast hit the dashboard or seatbelt at 50mph, there are very few ways your implant could have sustained the force necessary to rupture it. Put that concern to rest! Best wishes!

Jed H. Horowitz, MD, FACS · Answer

Depending on the reason for #revision, it's typically  best to wait approximately 6 to 12 months to undergo the next breast procedure.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation. It's best to consult with a board-certified plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision. Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes.

Martin Jugenburg, MD · Answer

Looking at your pictures, it seems that the right implant is sitting higher than the left one.  This could be a pre-existing asymmetry of the breast.  If you have them under the muscle, it is possible that your right pectoral muscle is tighter and it takes longer for it to relax and allow the implant to come down.  Another possibility is that the muscle on the right was not as released as on the left.

	You should talk to your plastic surgeon about your options which may include downward massage on the right side, or a surgical release to get a better symmetry.

	Sincerely,

	Martin Jugenburg, MD, FRCSC

	Toronto Cosmetic Surgery Institute

Shaun Parson, MD · Answer

Thanks for your question. From your photo it looks as if the right implant might have developed a capsular contracture. It would be very unlikely that the right implant would be ruptured at this point in time. It is more plausible that you have developed tighter scar tissue around this implant which is acounting for the assymetry. I would talk to your surgeon but it might involve a surgical adjustment where the scar tissue is released so that the implants sit at the same level.

Tom J. Pousti, MD · Answer

Thank you for your question.

	It would be in your best interest to go in and discuss this with your surgeon as he/she knows your history the best.  It is very common, however, to have one side settle at a slower rate than the other side - I see this often.  I suggest aggressive downward massage on the side that hasn't settled to see if you can help the implant settle.

	Again, because your surgeon knows you best, discuss this with him/her and get his/her advice.

	Best wishes.

Steven Wallach, MD · Answer

It is always helpful to see preop photos. The right breast in the photo does not look like it has come down as well as the one on the left. This can be for several different reasons. It is best to be evaluated by your surgeon. Good luck.

Darryl J. Blinski, MD · Answer

A posted before photo would have been helpful. But in any case it appear as if you have a minor to medium capsular fibrosis or a poorly done surgery on the dissection of the right pocket. Best to be seen by second opinions because very hard to help over the net.

Mahmood Kara, MD - Account Suspended · Answer

Hello. Thank you for your inquiry and congratulations on your surgery!

It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

Please ensure to get cleared by your doctor before engaging in specific physical activity before the 3 month healing period has ended as the healing stage is crucial for healthy results.

It generally takes around 6 months to a year to see your final results. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place. Should a revision cross your mind, it is best to wait at least 6 months to a year before doing so.

Our tips for recovery following breast augmentation are to wear a supportive sports bra for 3 months post-operative and refrain from lifting anything heavier than 10 lbs for 3 weeks as we don't want any strain at your incision sites. Make sure to keep the area of your stitches clean by cleansing with hydrogen peroxide daily. Showering is encouraged! But, no sitting in water for 2 weeks following surgery (no baths, hot tubs, pools etc.).

Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

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