My Breast Implants Are Uneven After 3 Months, Do I Need a Revision? (Photos)

I am extremely upset. I had a BA back in June 21, 2011. It is over 3 months today. I had under the muscle, mentor,smooth saline, 525 cc. The left one is firmer, higher, with rippling, and I can clearly see the difference after taking these pics today. Massage is not helping. I am afraid my doctor ruined my breast. I think, I am pass the point where massaging will help. I posted in here about a month ago, but had no pics. My PS says to wait 6 to 9 months to see if I need revision! Please help!

Doctor Answers 11

Asymmetry 3 months after BA

I agree with what Dr. Rand has said.  The only thing I would add is, "Which breast do you like better?"  It may be too late to try this, but if you want to try to raise the right breast to match the left, get a bra with firm but well-padded underwire support and cut out the material in the cup on the right side and wear 24/7 while you are waiting for things to heal over the next 3-6 months, making sure that the implant is lifted in the process to match the left side.  Make sure that that is OK with your plastic surgeon. Again it may not make a difference, but if it works you will have saved yourself another operation. 

Milwaukee Plastic Surgeon
4.8 out of 5 stars 27 reviews

Your breasts

Thank you for the photos.  The lower breast has bottomed out which is not that uncommon from large implants  The perkier breast may be perky because of a capsular contracture.  It's tough to tell without an exam.  The good news is that this is not a particularly difficult revision.  I'd wait at least 6 months from surgery to go back in to correct.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 31 reviews

My Breast Implants Are Uneven After 3 Months, Do I Need a Revision? (Photos)

Thanks for posting your photos. Yes you need revision, sorry. I see bottoming out in the right and possible capsular contracture in the left. Seek second opinions from boarded PSs in your area, like Dr Repta, Corey (both post here on RealSelf). 

Uneven implants at 3 months

It's hard to say without seeing the before pictures.  Many women have subtle asymmetries that are not noticeable until after putting implants in place. Placing a large implant in a breast is like placing a magnifying glass on your breasts....any asymmetry will be magnified and more noticeable.

It is likely that you had some nipple and fold asymmetry before surgery but again, I haven't seen the before pictures. If the firmness on the left gets progressively worse, then you may have a capsular contracture.  This is a function of scar formation and not necessarily anything the surgeon did at the time of surgery.

A wait time of 6-12 months is not a bad idea. I have seen breasts soften and drop 6-12 months after the surgery.  Sometimes one side drops sooner than the other.

Time will tell if the left side will drop into position.  I wouldn't be in a big rush to undergo surgery too soon. Go back to your surgeon with more questions if you need to.  If you are unsatisfied, you can see another board-certified surgeon in your area for a second opinion.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 150 reviews

My Breast Implants Are Uneven After 3 Months, Do I Need a Revision? (Photos)Answer:

I agree with Dr. Laverson. When your shoulders are more even in the picture, the bottoms of your breast and nipples are more even and although not perfect, I think very acceptable. I really don’t think your breast is ruined, tho.. Maybe a bit higher but not ruined..But to better evaluate the position of your shoulder and the relation of the breast, you should be seen in person. Dr. Repta is here in the Valley & I am as well but as always, let your surgeon know how you feel and give him a chance!

John J. Corey, MD
Phoenix Plastic Surgeon
4.5 out of 5 stars 35 reviews

Breast asymmetry after augmentation

You submit three frontal photos, although the one on the far right is not exactly frontal.  From left to right, your left shoulder becomes increasingly more elevated than the right shoulder.  If you elevate your left shoulder, the left breast will also elevate.  The asymmetry in the far left photo is minor, and in my opinion, not unusual, unexpected, or abnormal after augmentation.  Oblique views would help clarify implant position relative to the nipple areola complex.  Your breasts are not ruined.  Compare the one on the left to your pre-operative photos.  525 cc prostheses will likely continue to soften, stretch skin, and gravitationally settle further during coming months.   Enjoy your new breasts, and don't seek perfection, because it is not possible to achieve.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Deciding on a breast revision


My office received your email and will be contacting you on Monday.  It sounds like you are unhappy with your breast augmentation result and uncertain about continuing with your current plastic surgeon.  I think getting a second (and third) opinion would be beneficial to guide you along this process.  There are many well trained plastic surgeons in the valley that could provide a you with a free consultation including my office.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 154 reviews

Uneven breast augmentation

Thanks for the photos but without preop photos we can't be of as much service.  We need to see how much of the asymmetry you now have is a magnification of what existed already and how much is a result of the surgery, scar tissue etc.  You may have an early capsular contracture on the high side, or you may have bottomed out on the low side or maybe some of both.  The strong likelihood is that you will need a revision but please know that with revisions, your larger implants will make success less probable.

Post op assymmetry

Waiting 6-9 months allows the tissue to mature or heal from the first surgery and in some instances, even after 3 months, the implants soften and drop..  There are several questions that need to be answered to determine the best approach to correct your issues.  Firstly, how much asymetry was present before you had the surgery? Next, was there adequate discussion regarding the size of the implants? Large implants particularly saline implants are more likely to show rippling and to be bottom heavy particularly if the breasts are droopy before surgery.  Be patient, continue to massage  and ask to see the pictures that were taken before surgery. The best approach to correct the asymmetry if it persists after 6 months  will depend on  where the left nipple and the left inframammary fold  were preoperatively. Good luck.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.7 out of 5 stars 13 reviews

Breast Augmentation Revision?

Thank you for the question and pictures. I'm sorry you are experiencing a breast augmentation complication.

Yes,  I think you will benefit from revision of your breast augmentation. what type of breast revisionary surgery is necessary will depend on your physical examination and goals.  For example, if the higher breast implant is soft (no encapsulation  is present)  then correction of the lower breast implant (bottomed out)  may be all that is necessary. If encapsulation of the higher implant is an issue then surgery on both breasts may be indicated.

Generally speaking, one of the most common complications after breast augmentation surgery is implant mal-position. This occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

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.