Fixing Uneven Breasts After Breast Augmentation?

I agree with the other physician, I would not panic at 3 weeks and start thinking about revisions.
ALL PATIENTS have pre-existing asymmetries of their breasts and it is important to point them out in detail because many of the asymmetries CANNOT be fixed by breast augmentation alone. For example, the nipple position is slightly different (as it is in most patients) and that was undoubtedly there prior to breast augmentation.
I do not put that much stock in breast sizers...They always slightly "overestimate" the size that a patient can expect. I see this more of a problem with silicone gel than saline implants and typically have to go "plus 1" size from the sizers for patients to be happy. I also believe in using a sterile breast sizer at the time of surgery because there really is not better and more accurate place to determine the best implant size for that patient's tissues than at surgery.
I personally do not favor shaped, "teardrop", or anatomic implants but that does not mean that some surgeons get excellent results with them.
It doesn't appear that the left breast is much smaller and it takes a complete 3 months for implants to settle downward even with doing implant displacement exercises...the only thing in your case is that the textured anatomic implants won't settle as much as a smooth round implant because it "locks into" the capsule, but at 3 weeks the capsule is still not completely formed so it is still worth being aggressive with implant displacement exercises.
Even if you needed an "exchange of implants" which I would consider at 3 months if you were still unhappy with either size or position of the implants, the exchange is even a faster recovery for the patients as your tissues are already "stretched" and switching out implants even if you decided on a slightly bigger smooth round silicone gel implant wound not be difficult and you would do fine with that.
Realize that no women's breasts are perfect mirror images of each other and no breast augmentation can give you that. Wait and see where you are at 3 months and then talk with your surgeon about your options.
I hope this helps!

It is still quite early into your healing and it's not uncommon for #asymmetry as each breast heal quite differently. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete #healing, they will be more similar and natural. 

#Healing will continue for 2-3 months following your #Augmentation #Mastopexy procedure. There may be some swelling, bruising, malposition, color differences. Sensation will be abnormal. Scars will also be changing.But, it can be up to one year see your final result. Your doctor may require you to move or massage the implants within the breast pockets during the #postoperative period. #Textured implants do not require breast massage. You will be informed about this at your post-operative visit. You must have patience, but if there are any causes of concern, ask questions of the doctor or the nursing staff.  

It
is quite common for the two breasts to heal differently. One may swell more,
one may feel more uncomfortable, or the shapes may differ initially. After
complete healing, they should look more similar and natural. Patience is
required, but if you are concerned, ask questions to your doctor or the nursing
staff.


#breastrevision
#breastimplants

Your post-operative asymmetry is probably related to unrecognized and untreated breast sag. This appears to be present on both sides. The left breast appears to have more sag than the right side. Optimal results following cosmetic breast surgery are dependent upon an accurate diagnosis of the problem. Although you have bilateral breast hypoplasia which has been treated, your breast sag has not been addressed. Without treatment of this problem breast symmetry is not possible.
Although, the position and size of your breast implants are areas of concern, this does not appear to be a major problem. These problems can easily be addressed by revising the breast pockets and exchanging implants. The type of implant used would have a minor impact, relatively speaking, compared to the issue of breast sag.
Revisional surgery will be necessary to correct this deformity. This would most likely require a left sided breast lift and possibly a right sided procedure as well for symmetry. Discuss your concerns with your plastic surgeon. Your surgeon has specific knowledge about your past procedure and will be able to utilize this information to hopefully solve your problem.

There is still swelling at 4-6 weeks and the breasts may look uneven because of the swelling.   If swelling  was indeed perceived later on, then I think a breast lift would be appropriate for the patient shown.

I can notice that you have inherent breast asymmetry as well as breast sagging. it also seems that your left breast implant might be a bit higher than the right one. changing to a round breast implant will give you a better cleavage. bigger impalnts will also make them look better. You need discuss things in detail with your surgeon and have patience.

First of all, if they are shaped cohesive gel implants, then they will not drop any further. Shaped implants are textured and stay where they are placed. You seem to potentially have had asymmetric breasts to start with and I wonder if your doctor had pointed that out to you beforehand? Either way, I do not think that more time will lead to significant enough changes that will make you more pleased with your results, and I do agree that you will need a revision at some point. I recommend waiting at least 3 months prior to reoperating to give the tissues a chance to fully heal before you re-traumatize them with more surgery. I do think that you will have a better, more natural results utilizing smooth, round implants, but you will most likely also require a breast lift to provide you with that result as well. This means more scars on the breast. You have a to think about and to discuss with whichever plastic surgeon you wind up seeing. Good luck!

It's hard to speak with complete confidence about your case without having seen your preop photos, but based on this one photo, I think a lift (mastopexy) should certainly have been considered. While it involved more incisions, I think it would have given you a far better chance at a more natural result, with improved symmetry and improved breast shape. In addition, a round implant would have been my choice in your case as well.
At the moment, the worst thing you could do would be to go back in for more surgery. I would recommend letting things settle over the next few months, and then seek out several opinions in your area so that you can feel comfortable with the surgeon you choose. Don't be surprised if he or she recommends a lift and perhaps even an implant exchange as the best approach to getting you a better result.
Good luck,
Dr. Salemy

Clearly there are many issues here which need to be addressed:
1) Volume discrepancy: Right larger
2) Nipple dystopia: Left lower
3) Ptotic glandular tissue: Pseudoptosis with involutional atrophy
4) Enlarged Areolae: Probably larger than average 4.2cm
5) Mild constriction: Left sided narrow base diameter
Each of these issues needs to be addressed. To some degree in quick summary, you may benefit from biplanar approach radial relaxing incisions, mastopexy. All of these interventions may not be required but would likely result in significantly more scarring associated with more risks and costs; these procedures may need to be staged (more than one operation to avoid possible compromise of the blood supply to the nipple). However, plastic surgery is an art and open to interpretation. It is no doubt that you will get differing opinions from different surgeons and that is to be expected.

Thank
you for the question. You are still in
the post operation recovery stage. It is
not uncommon to feel pain, itchiness, and swelling during this
period. It usually takes about 8-12
weeks for the wounds to heal and around 4-6 months for the implants to fully
settle. It would be best to visit your
board-certified plastic surgeon and get a full assessment if you have concerns in the next few weeks. Best of luck. Dr. Michael Omidi.









An
in-person exam with a board-certified plastic surgeon is the best way to assess
your needs and provide true medical advice.