Does it look like I have two different size implants or do my breasts look asymmetrical? (Photo)

Hello,You more than likely have the same sized implants. What is affecting your perception is the implants' position relative to the breast tissue. On one side it is good position, on the other it is too low. This is what you should be talking about with your surgeon, not implant size. Best of luck!

It is still early. I would wait for all of the swelling to resolve.   I also recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Dear Louie714,it is impossible to tell implant size just by looking at your photo or by examining you. I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you are still in the very early stages of the healing process.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues around the implants are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery 

to let you know exactly what you go.  If you started out obviously fuller on one side, it will still be a little bigger but usually, when you add volume to breasts, it diminishes the ability to appreciate the size difference.  You do have an obvious asymmetry in volume but try to be patient and let yourself heal and once healed, if you are obviously asymmetric to where it remains obvious, talk to your surgeon for options on how to make this better.  You could replace your implant, you could have fat grafting, or you could have the larger side reduced slightly but this comes with scars.  I'm hoping you will heal closer to equal and not need anything done.

You state that you had preexisting asymmetry. If that is the case, then the use of identical implants on both sides would be EXPECTED to maintain some asymmetry. Sometimes, that is not a bad decision if there is under about 25g (25cc) of difference based on the fact that implants are not made in precise increments of less than about 25cc in silicone. Otherwise the two devices would have slightly different diameters; this is ok in most patients but occasionally the right decision is to accept a small amount of asymmetry of volume that is within subtle, normal limits.You may also have had asymmetry of breast POSITION, which is often retained unless specific maneuvers, which are not always successful, are done to deliberately try to correct this asymmetry of position. Usually this kind of correction of asymmetric preop position requires a lift technique, which typically means different/additional incisions than what you have for a straightforward augmentation.Your asymmetry is fairly modest on the photo but only an exam would suffice in order to properly assess that. You are early in the healing process, so the implants may settle further and then you can discuss whether that is pleasing or not. The last comment is that nobody can tell you on a photo OR exam what size implants you have. It depends in part on how much volume you had before surgery (which requires preop exam/photos) and also it's kind of like a "guess your weight" exercise; an experienced observer may come close but can not tell definitively. The definitive documentation is your operative report and the implant card/stickers you should have gotten from the surgicenter. Implants have a unique serial number and both the SN and the catalog number should be on the documentation you have for each side. This will at least help you answer whether the same size/style implant was used on both sides. It would be rather rare for a surgeon to "accidentally" use the wrong size implant and your documentation should show what was used unequivocally. Ask the facility/surgeon for copies if you can't find your implant card.

The result is probably from your natural and preexisting asymmetry, but if you are concerned, ask for copies of the operative notes and nursing notes which will contain stickers from each implant to show what specific implant is in each breast.