Different Breast Implant Sizes for Slightly Asymmetrical Breasts?

Question

One of my breasts is A cup and the other is AA. When I breastfed, my A cup breast was a lot bigger than my AA cup breast (the larger one was probably a DD and the smaller was medium C). I am considering getting breast implants and although you can't tell the difference much  (because they are now both so small), I am worried that the difference will be much more noticeable after augmentation, just like when I was breastfeeding.  If one size only makes a slight difference, then shouldn't I get a slightly larger size in my AA breast?

Darrick E. Antell, MD, FACS · Answer

In cases of breast reconstruction after a mastectomy we often place different sized implants to improve assymetry.

	However, please understand that more than 1/2 of all cosmetic surgery patients I see have some degree of breast assymetry. In the majority of cases we use the same size implant as the percentage difference becomes smaller as the breasts become larger.

	For example: If one breast was 100cc to begin with and the other was 110cc and you placed two 300cc implants. The final size would be 400cc and 410cc. That small of a difference would not be noticed.

	The intial 10% difference, becomes only a 2.5% difference after the 300cc implants were placed. If you chose a saline implant, you could potentially add extra fluid to the smaller impant.

	But remember, your breasts are sisters, they are not identical twins.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Breast asymmetry is very common, particularly size asymmetry.  If you are looking to decrease the asymmetry from one breast to another, then you have several options.
1)  You can reduce the larger breast with liposuction or a traditional breast reduction technique
2)  You can enlarge the smaller one with fat grafting or an implant
3)  You can enlarge both but use different size implants
4)  A lift procedure may also be needed to help address differences in shape, nipple position and areolar size.
I would visit with a board certified plastic surgeon to discuss your options in more detail.

Michael Constantin Gartner, DO · Answer

You can have two different sized implants if you want bigger breasts overall, and the size will be selected to achieve better symmetry in size. Talk to a board certified plastic surgeon for more advice.

Otto Joseph Placik, MD · Answer

SEE VIDEO BELOW:
There are many different methods to manage breast asymmetry including: different implants or fill, lifts, reductions, etc.
The approach you suggest is reasonable. Be prepared that it may take more than one operation to achieve the best possible result.

Sam Jejurikar, MD · Answer

Volume is only one factor to consider when trying to determine the optimal correction for breast asymmetry.  The anatomy of your breasts, as well as implant dimensions, specifically height, width and projection also play a major role in bringing about symmetry.
For example, a low profile implant, for a given volume, may be more than 2 cm wider than the same volume in a high profile implant.  To compensate for that, the high profile implant ends up proving more projection and more upper pole projection.  Even though the volume may be the same, the breasts will look very, very different.  Even for the same style of implant, in some cases, a small volume disparity looks better than a different sized implant, because of the disparity in implant dimensions. The amount of asymmetry will help you and your plastic surgeon make the best decision for you.
You would really benefit from an evaluation by a board-certified plastic surgeon.  Best of luck!

Steven L. Ringler, MD, FACS · Answer

It is not a problem to treat women with breast asymmetry. In fact, many women have different size breast. For smaller volume differences, it often is corrected just by the breast augmentation procedure with equal size implants. For example, if you have one breast that is 200 grams and the other is only 100 grams, if you add 300 gram implants to both you end up with 500 grams on one side and 400 grams on the other. So in this example, without using different implants, we are reducing the difference from 50% to 20% just by adding equal volume to both. 
Of course, we could always use a larger implant on one side if it would improve the symmetry of the result. Whether with saline or silicone gel implants, the options still exist to correct breast asymmetry during breast augmentation.

Farbod Esmailian, MD · Answer

Breast asymmetry is very common and you are not alone.  In general the surgeon will discuss these things with you in a consultation and explain to you what can be done.  The implants that I use give us a range to fill them, so you can adjust for this difference in the operating room when the patient is sitting up.  You can do this for saline but not silicone.  Silicone comes prefilled, so your surgeon will have to determine ahead of time how much in cc is the difference.
Good luck

Richard Baxter, MD · Answer

Most women have some degree of asymmetry if you look closely enough. The decision of whether or not to correct this with different implant sizes can be very tricky however. One reason is that you want to match the base diameter and projection of the breasts in addition to the volume, and this could require having a nearly infinite number of options available which of course we don't. There are however a much larger number of choices now, and so with some dimensional planning you should be able to come close.

Scott E. Kasden, MD, FACS · Answer

Depending on the size discrepency, a same size implant may be all that is needed with more saline in the smaller breast. On the other hand, if the difference is significant, two different size implants will be required. Only exam can tell.

Christopher L. Hess, MD · Answer

First understand that symmetry does not exist in nature.  All women are asymmetric in terms of all body parts especially breasts.  So this is the norm that plastic surgeons deal with for each augmentation.  During a consultation for augmentation the surgeon must estimate the size difference and plan accordingly.  The use of sizers in the office helps. 
The use of saline implants allows for very small changes in implant size.  Silicone implants have fixed sizes at a minimum of 25cc's.  But even though we try our best to correct the asymmetry there will always be differences in the breasts.  It is essentially impossible to make asymmetric breasts symmetric.  There are too many postoperative changes that occur with the tissues.

Different Breast Implant Sizes for Slightly Asymmetrical Breasts?

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