Breast Implant Size for Someone with Slight Asymmetry?

I am 5'3 115lbs and am a 34a on my left side and 34aa on my right. After my consultation I was advised to get Natrelle silicone gel implants over the muscle and moderate profile. She gave me two options. Option 1: 304ccs on my left and 371 on my right or Option 2: 339ccs on my left and 391 dcs on my right. I am looking to become a C cup but am afraid the 391ccs on my right side might be too big and I am afraid of stretching, etc. I think the two different size implants are making me more confused!

Doctor Answers 10

Asymmetry corrected at surgery

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Since you are a 34 A, each 100 cc of implant will correspond to 1 cup size change.  If you want to go from a 34 A to a 34 C, then 200 cc implants would be required.  Since you are smaller on the right side, you will need slightly larger than 200 cc implant.  Perhaps a 250 cc implant will be optimal for you.  It is usually best to do the smaller side first and place the implant.  Then size the opposite breast on the table.  This is the most accurate technique to create symmetry.  I always recommend the smallest implants possible and placed in the retro-pectoral position.  This gives the most natual look and feel.  Larger implants will rapidly descend inferiorly and laterally and will require revision.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Correcting asymmetry is tricky

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You have two issues to consider.  Correction of the asymmetry and enlargement of both sides.  Sounds like your plastic surgeon has assessed you and found a good combination of implant sizes to give you good symmetry.  So what you need to do is to forget about the numbers, and go with what looks good.  If you are unsure, review the choices with your plastic surgeon again and try on different size implants (but keep in mind that after the surgery they'll look a little smaller than when they sit on top of you chest).  Find a pair breast implants that look like the size you want (once again... forget the numbers and cup sizes, chose the look you like not the letter that sounds good) and that give you good symmetry.  Have a realistic expectation that despite her best effort, your plastic surgeon will not be able to give you perfectly symmetrical breasts.  She can correct the volume difference to a degree, but more difficult is to correct the shape asymmetry.  Review your breasts in a mirror.  Your breasts have a certain shape to them as a result of the relatively stiff and inflexible breast gland tissue.  Unless the breast tissues is completely cut out, it will be there sitting on top of your breast implant and contribute to the final shape of your breasts.  

Martin Jugenburg, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Implant choices

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Without a proper exam, it is difficult to suggest to you what is best.  Of what you chose, there is only about a 20-30 cc difference in implants, which is not that much. Good luck.

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

Breast Implants and Asymmetry

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Implant sizing can be complicated and should be based on a variety of measurements and considerations: various breast and chest wall measurements and your desired size and the look you are going for.  This can only be determined in person and sometimes the final decision must be made by your plastic surgeon during the surgery. The key is to find a surgeon that you trust, has experience with breast augmentation and can show you before and after pictures of actual patients. 

  In someone as thin as you, I would likely choose to place the implant under the muscle and may use an anatomic (shaped implant) to give you a more natural looking result, but again, this can only be decided after examining you.

  The MOST common complaint of breast augmentation patients is that they wished they had gone bigger. The options you have are actually very close in size so I wouldn't stress too much no matter which one you choose. Good luck!

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Asymmetry is accentuated with augmentation

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If you notice the asymmetry Preop it will be more visible post op. I think the best way to judge your surgeons judgement is to see before and after photos. Ideally you choose the size for the bigger breast and you can pay for a sizer to determine the beat implant for the alternate breast.  You should break down the question into two. First determine the size you want and then the shape. The surgeon should be able to translate that into the correct implant to use. It is not unusual to use different sized implant to accommodate breast size differences. Good luck!

Kimberley Lloyd O'Sullivan, MD
Providence Plastic Surgeon

Breast implants and asymmetry

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Many surgeons are very good at choosing implants before surgery that effectively deliver the results that patients are hoping to achieve. But, I personally do not like to fully commit to a particular size before surgery, especially in cases of marked asymmetry. I prefer to use intra-operative sizers of a small range of implants to determine what looks appropriate while keeping in mind the goals that my patients have communicated to me.  It helps to have a consignment of breast implants available and I realize that not all surgeons will have this luxury. I don't think that you should have to decide exactly what size implants that your surgeon will be using. You should rather be able to discuss the sizing options with your surgeon and she should be able to guide you effectively. I also question your surgeon's advice to place the implants over the muscle. While this is not necessarily a bad decision, the overwhelming majority of surgeons now prefer a submuscular or dual plane approach for many reasons. You should fully understand the reasoning of your surgeon to use the subglandular approach before heading to the operating room. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 90 reviews

Implant sizing with asymmetry

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You are really asking two questions: 1) what size to go with, and 2) how to address the asymmetry.  I use the Mentor sizers in my office, and I find that they are especially useful in cases of asymmetry.By putting two different sizers in, we can see how much it will take to make up the difference.  It sounds as if your plastic surgeon feels that you have about 60cc of difference in your breasts. As far as how big of an implant, that is partly a matter of taste and partly a matter of how much the skin will stretch, as you have pointed out.  Without a picture and further history regarding pregnancies, weight fluctuations, and your esthetic goals, it is difficult to say online what would happen with a given implant. Searching some of the online databases may be helpful in that you can find someone of similar height and weight and see how they looked with a given size of implant. You can begin to see that plastic surgery is part art and part science. Good luck!

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast Implant Size for Patient with Breast Asymmetry?

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As you can imagine, it is not possible to give you precise advice without direct examination and a full communication  Of your goals. Generally speaking, especially for patients with your body type, I would recommend sub muscular (his dual plane) press on Tatian ( preferably with silicone gel breast implants).

Prior to surgery  careful communication regarding your desired goals will be critical in determining which breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "full C" etc means different things to different people and therefore prove unhelpful. 
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

 In my practice,  the use of intraoperative sizers  and careful measurements allow for selection of breast implants that best improve existing breast asymmetry.  The decision about exactly implants will do the job is made intraoperatively.

 Remember, that  achieving realistic expectations prior to surgery is critical; absolute symmetry of the breasts will not be achieved despite best efforts.

 I hope this helps.


Options with Asymmetry are More Confusing.

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Every patient and surgeon has to decide upon incision, position (above or below muscle), silicone or saline, and implant size and contour. 

Without photos it is hard to make recommendations, and even with photos, the options that would be suggested are much better done with the benefit of an actual exam. 

Just based on what you have written, I would likely prefer silicone implants, as have been suggested, but I would usually prefer placement under the muscle unless there is a pressing reason to put the implants above the muscle.

Given that your breasts differ by a cup size, I would expect to suggest differing implant sizes to try for best symmetry. I try to make a tentative decision at the consult or pre-op visit by having patients try on sizes and looking to see how different the implants must be to get size symmetry. The actual decision may be deferred to the operating room, however. 

With a 34 band, these implants should get to to a C cup, but remember, there are no standardized cup sizes. Many of by patients have 3 different cup sizes in the bra drawer, all of which may fit. 

Thanks for your question, best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon


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Having asymmetrical breasts is very common is every women, every woman has some kind of asymmetry. Your asymmetry does not seem to make a big difference. If you’re an A cup and want to be a C cup you looking in the right range of implants. I’m not sure why you would choose over the muscle to going under the muscle?? You can also get saline and have them put more saline on one side then the other. Without actually seeing you it’s very hard to give you adequate advice. Good luck


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

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