My left breast is slightly bigger than the right. Should I go with 2 different size implants or keep the same size? (Photo)

my breast diameter is 10cm - implants chosen: 485cc L 520cc R - 55FF projection, Allegran High profile sub-muscular placement. After trying on these sizes, I feel there is a noticeable difference in size and having second thoughts. I think there is a slight difference in my natural breast size but feel that I should go with the same size implants. In your professional opinion, based on my photos, should I stick with the sizes chosen or choose the same size implants?

Doctor Answers 13

Different implant sizes

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The larger the implant the more likely I am to use to the same device. When choosing different implants sizes, the devices begin to have different dimensions. With conservative implants, of lower profiles, this tends not to be obvious, as the difference is 1 or 2mm but with larger higher profile implants over time, since the implant tends to take over the breast and the difference can be up to 5mm between sizes, this can be noticeable. Also I am an engineer and like numbers and mathematics. If your breasts currently have 100cc volume difference and 300cc total volume on the larger side, their volume difference is 33%. If you add 500cc to both sides the same 100cc difference has dropped to a 12.5% difference! That being said, 485 and 520 are close dimensionally so if you were my patient I would discuss that I will try two 485s, one 485 and one 520 and two 520s and make a decision about what looked best during surgery. My patients pick implant styles and their breast/chest pocket determine the size implant placed. I never let patients fixate on a number as that is not how you will judge your result. Best of luck. 

Stuffing implants in your bra isn't very accurate.

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It is up to you if you want the same implant on both sides, but you will still be asymmetric.  I use a sizer in surgery to "test-drive" the implant before it's placed.  Sometimes, 2 of the same are best, but I'd be surprised in you.  I think you would do better with 2 different sizes.  Talk it over with your surgeon. Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast implants

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Dear missgaga,

Thank you for your clinical post and photograph. The photos taken, particularly the front on view shows the left breast to be significantly larger than the right. In these situations I would recommend you seek out consultation with a certified plastic surgeon that has a Vectra 3D breast imaging photo station in the office. The Vectra 3D takes photographs in three-dimension and allows the patient to select on different sized implants to see a very close approximation of what the final outcome will look like at 6 months. I’ve been using the Vectra 3D for 6 years and it has greatly minimized patients who are dissatisfied with the augment style and size selected. In cases of asymmetry, simply by clicking on different size breasts that are slightly large on the right side, you can often arrive at a improved balance and symmetry by selecting symmetrically sized implants.

I believe it would be in your best interest to ensure you undergo some Vectra 3D imaging and select asymmetric sizes. If you like that 500 gram range you’ll want to likely pick an implant that’s between 30 and 40 grams larger on the left side, as long as the base width is acceptable for the soft tissue breast mound that you have currently on the right side.

I hope this information has been of some assistance and best of luck.

For more information, please review the link below. Also check out the areas on Vectra 3D imaging including the television shows and video that show patients doing this kind of pre-operative breast implant selection.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 101 reviews

Different size implants

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Thanks for your question.

We cannot decide it because the photos on website have much distortion.

The surgeon can only have conviction when he inserts the sizer in the OR after every dissection procedure is complete.

So please talk with your surgeon about that thoroughly.

Good Luck.

Joo Hyuk Lee, MD
South Korea Plastic Surgeon

Breast augmentation sizing using breast implant sizers

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Thanks for posting your question. I am happy to try and help you. It is important to remember that a board certified plastic surgeon will be your best resource when it comes to an accurate assessment of your situation, and concerns.

Having said that, thank for your height and weight and breast size estimates, they do help. There is really no way to accurately predict what size you would like without an examination. During your examination and consultation, you should try on some sample sizes and see what you are comfortable with. Then the PS can help explain with the size and current condition of your breasts.

If you have accomplished this step, then trust your plastic surgeons advice as to what would be the best size for you. They have the experience. If you are uncomfortable, go on another consultation.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Correcting asymmetric breasts

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When smaller breasts have a slight difference it becomes much less important relatively speaking when the size in made larger.  That said, all breast surgery should be customized.  Generally in your situation I would bring several sizers to the OR and chose the best combination regardless.  It might be that the same implant is still the best.  This highlights the importance of choosing the general range for implants ahead of time but choosing the exact implant at the time of surgery. Customization is so key in this setting.

Dr Rodger Shortt
Oakville Plastic Surgeon
Director of Cosmetic Surgery Training &
Ass't Clinical Professor,
McMaster University

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 85 reviews


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Thank you for your question and photos.  In my practice, two different sized implants are used to correct for asymmetry like yours.  However, it is very difficult to get the breasts to look EXACTLY the same after augmentation.  As long as you have chosen a surgeon who is board certified in plastic surgery and is an expert in the breast augmentation with implants procedure, then I would trust his or her opinion regarding what would be best/realistic for you.

All the best,

Dr. Results
Miami, FL

Breast asymmetry

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Anytime there is a significant asymmetry, the case can be quite difficult. Not only are they different but the smaller one looks very narrow. Best of luck

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

Different Size Implants

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That is a difficult call to make with just pictures but your size difference pre-op is noticeable. When patients have a noticeable difference, I usually recommend 2 different size implants. There is no way to make this perfect, especially if you choose silicone implants. So, your choices really are to keep the same asymmetry or try to get closer but not perfect. I think the difference you are choosing looks good from what I can see here. If you have any concern, you should head back to your surgeon's office to try on sizers again prior to surgery. Best wishes!

Breast asymmetry

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Its been my experience that as the implant gets larger in a naturally small breast the percentage of the amount of total volume gets less and less. Then the small differences in the implant volume become more noticeable than those of the natural breast. 3D imaging like Vectra would allow you to visualize befor surgery what the different size implant would look like. Good luck

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

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.