Breast Uneven After 7 Months! What to Do? (photo)

I had breast augmentation done December 16 2012 my breast before surgery was a little uneven(right breast had a slight sag but not really noticeable to me) my 4 month post picture my breast still a little uneven but not really noticeable they looked great, but at my 6 month post I noticed my right breast has changed dramatically!! I went to my PC to address my issue and he told me that there is nothing that can be done!! I paid 5600 for my surgery and I am VERY unhappy, Please any advice.

Doctor Answers 11

Asymmetry After Breast Augmentation

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Thank you very much for your photographs.  BTW, why did you photo shop your pre op picture?  At any rate, asymmetry is quite common.  Your pre operative photograph shows that your right breast had a downward tendency even before surgery.  Breast augmentations accentuate any asymmetry.  Also, since your nipples on both sides are pointing downward, this may have been caused by a capsular contracture.  All contracted implants move upward.  This question can be verified by checking to see if your breasts are hard. 

Since your plastic surgeon says that nothing can be done, you need to get a second opinion from a Board Certified plastic surgeon.

Uneven Breast Augmentation Options

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Hello. It is clear that you have had a complication with your Breast Augmentation, but you need to be examined by your surgeon to get an accurate diagnosis. Your doctor will know how to best approach the situation, but it is possible that you will need a revision surgery. To ensure that you do not have further complications, be sure that your surgeon is a board certified plastic surgeon.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 79 reviews

Breasts uneven, what can I do?

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Difficult to diagnosis over the internet, but i will tell you that something can be done, i would recommend a second opinion from a BC PS to discuss options and discover what is wrong, good luck!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 91 reviews

Uneven Breats After Augmentation

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Uneven breasts after this procedure is not really uncommon, however you do have a significant asymmetry.  In reviewing your photos and from your history:

  • Your shoulders aren't at the same level in your postoperative photos. This can significantly exaggerate your asymmetry
  • You may have developed a capsule around the right implant which will worsen the more pronounced sagging that you are seeing.

An examination would determine if you have a capsular contraction on the right.  However, because of the uneven position of your nipples it would appear that you may well need a right mastopexy.

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 21 reviews

Breasts at 7 months uneven

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Thanks for the photos!  It  is hard to predict what is causing your problem without a proper in office exam.  The exam will tell if the implant is deflated, if there is a capsule distorting the shape, or if it is just ptosis of one breast?

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Asymmetry after Breast Augmentation?

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I'm sorry to hear about the concerns you have about  breast asymmetry after breast augmentation surgery. This breast asymmetry is obvious in your longer-term postoperative picture. What is causing the breast asymmetry is critical to diagnose in order for an appropriate treatment plan to be determined. This diagnosis will depend on in-person physical examination.

For example, your breast asymmetry may be related to capsular contraction, breast implant displacement, breast implant leakageā€¦  Again, in-person examination will be instrumental in determining the cause of the breast asymmetry and formulation of a treatment plan.

Best wishes.

Uneven Picture

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Hello from Miami,

The most obvious thing I noticed is how distorted your stance is in your 7 month photo. Your right shoulder is about three inches lower than your left, making your pre-existing asymmetry worse. Take your photo in the same stance that you took your 4 month photo. You will see an immediate improvement.

 If you look at your before picture, your right breast is significantly narrower than your left, with a lower nipple position. This is evident in the 7 month f/u photo.

With that said, there is the possibility of a capsular contracture making the asymmetry worse. if both breasts are soft there might be a partial deflation deflation issue.Go back to your surgeon and discuss these options,,,if he still doesn't communicate with you it is time to find a new surgeon.

Good luck

Capsule contracture versus partial deflation

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If your right breast is firmer than your left breast it may be that you have developed a capsule contracture.  This is a process where the normal capsule that forms around a breast implant becomes too thick and too tight.  We do not understand the process completely but treatment options do exist.  Of all of the options that are available to treat capsule contracture the one that I usually recommend requires removal of the capsule and replacement of the implant.  There is a chance that you could have had a partial deflation of your implant if you had saline implants placed.  When saline implants deflate it is more common for it to be an "all or none" process, so a partial deflation would be on rare side.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 171 reviews

Breast augmentation and capsular contracture

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You are in a difficult position because the 4 month photo does not look too bad so the surgeon can rightfully say he did not do anything wrong. At 6 months you can see some capsular contracture on the left with flattening of some of the breast mound margins and a more visible upper edge of the implant. On the right the capsule has squeezed the implant into an elliptical shape and the breast tissue on top of the implant has fallen down so most of it and the nipple is below the middle of the implant.

You will need revision surgery with removal of the capsules on both sides. If the original implants were smooth it would be best to switch to textured. If the changes have not stretched the right breast skin too much you might not need a lift on that side. You need to see a few surgeons before deciding on what to do and choose carefully. Be sure to bring a copy of the operative report from your first surgery when you see a new surgeon. It does not sound like your original surgeon is willing to fix this. You do not want to end up with skin scars on the right that you do not need.

You are now at much greater risk of forming bad capsules after any new breast surgery than you were before the first one so adjunctive therapy like endermology after revision breast surgery should be considered.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Uneven breast after breast augmentation

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At your 4 month picture everything looks fairly symmetric.  Did you have saline breast augmentation?  It appears to me that you probably did.  My best guess is that if you had saline breast augmentation there has been a partial "deflation" on the right side between the 4month and 6month pictures.  There seems to be a bit of difference now in size and the right breast seems smaller and slightly more droopy. This did not seem present at your 4 month picture.  I cannot say for sure without examining you, but that is likely what has happened if you had saline breast augmentation.  The treatment would be to do a "removal and replacement" of the right breast implant with the same volume as you had originally.  It is also possible, but less likely, that you have an inferior malposition of the right implant. I cannot tell for sure but it appears to me that the breast, rather than implant is slightly "droopy" on the right which suggests partial deflation.  I would go back and see your plastic surgeon. 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.