What to Do For My Lopsided Breast Implants? (photo)

Question

I got implants 375 cc in left breast and 400 cc in right breast silicone under the muscle 6 mos ago. I have complained to my plastic surgeon that I feel they look very lopsided and the left looks more natural while they right doesn't. He wants to wait another 6 mos as he believes they will take care of themselves. I cry about them. I hate them. Is there anything I am do to encourage the right one to move down and look more natural. Any suggestions on how to handle this would be appreciated.

Jaime Perez, MD · Answer

Hello. At 6 months I would expect the implants to have settled into their final position. The right definitely appears to be higher though judging by the picture you posted. If it was my patient I would be ok performing a revision at 6 months post op.

	Jaime Perez, MD
	Breast Augmentation Specialist
	Plastic Surgery Center of Tampa

Robert F. Centeno, MD, FACS · Answer

Breast asymmetry is very common.  Trying to correct small amounts of asymmetry with different sized implants typically results in a different type of asymmetry.  If it is done with saline implants, small volume differences can leade to better symmetry with if the same size implants are used.  With silicone implants, since they are pre-filled, a difference in volume also means a difference in  base diameter.  This is probably the cause of your assymetry at the upper pole of the breast.  You should accept your pre-existing asymmetry and ask for one of your implants to be replaced witht the exact size of the side that you prefer.  This will get you better symmetry.  Waiting 6 months will not change the shape.  All the best!

Kenneth Hughes, MD · Answer

The higher implant may drop further.  However, preoperative pictures would be useful in this discussion to determine the position of the areolae.  Kenneth Hughes, MD Los Angeles, CA

Remus Repta, MD · Answer

Hello,

	Thank you for the question and photos.  It appears that you had some type of breast asymmetry before surgery as different size implants were selected.  The different implants are different in overall volume but also in width and projection.  From your post op photos I notice that your right breast is less full laterally (on the side) as well as at the bottom, and more full at the top.  At 6 months, if you are not seeing any more changes you should proceed with revision.  You will likely need pocket revision and may also need implant replacement.  There is a chance that you may also need a purse string areolaplasty if your areola positions are still asymmetric.

	All the best,

	Dr Remus Repta

Jourdan Gottlieb, MD · Answer

It would be really helpful to see some preop photos, and side views of the postops.

	Based upon the single photo, the implants look very even in terms of size and position. What does look different is the nipple/areolar position. SInce you have received different sized implants, you probably had size difference before surgery, and likely also difference in areolar position.

	A decision for surgery would be based upon more than just a photo, but I think a breast lift to make the nipples and areolas more even would be helpful. I don't see much reason for delay beyond this point unless there has been improvement over the past three months.

	All the best

Steven Wallach, MD · Answer

Without seeing pre-op photos it really is difficult to comment. More than likley you had some asymmetry to begin with.

Darryl J. Blinski, MD · Answer

Yes you will need revision surgery! And now is better than waiting 6 months. The question is what revision. If you could post before photos to we could see the asymmetry prior to surgery than a revision plan could be outlined.

Karol A. Gutowski, MD, FACS · Answer

It is hard to say from your picture but it looks like the implant are fairly close to symmetric but your nipples are on a different level. Could you post your "before" picture for comparison?

Jeffrey Zwiren, MD · Answer

Symmetry is always the goal with breast augmentation but it is important to remember that they are sisters and not twins. If you start out symmetric there is a greater chance that your result will be symmetric. The same is true for asymmetry. There must have been some differences in your anatomy and symmetry prior to surgery. Most likely this was taken into account. It is certainly fair to give it a chance to see if the breast will settle down over time. Vigorous massage can be beneficial. If one breast feels firmer than the other it is possible that you are developing a capsular contracture and this can account for the asymmetry. Your right breast does look bigger and rounder at the top and it is possible that you will need a smaller implant on that side. Your plastic surgeon is in the best position to understand your situation. If you desire a second opinion would be welcomed by all.

Peter E. Johnson, MD · Answer

Waiting is the hardest thing to do after breast augmentation. We don't have your before photo but it is likely that the skin envelope in the lower pole was tighter on one side. There is a chance that the higher implant (lower nipple and tighter lower pole) will drop down and center within the breast and six months can be worth the wait to see.

What to Do For My Lopsided Breast Implants? (photo)

Answers (11)

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