Why would my surgeon use the same size implants if my original implants were different sizes due to asymmetry? (photos)

This is of course a question for your plastic surgeon but here are a few things to consider: The volume difference of 20 cc between your saline implants equals 4 teaspoons, very small. The form-stable implants you and your surgeon selected do not allow for incremental differences that small, so your surgeon may have adjusted the skin envelope or other things to compensate in other ways. If a revision is needed then it would be likely to be something along those lines rather than anything with the implants.

I am sorry to hear about your concerns after the revisionary breast augmentation surgery. Your plastic surgeon will be your best resource when it comes to an accurate answer to your question. Generally speaking, achieving  “perfect” breast symmetry can be quite challenging;  there are many variables involved, besides breast implant size/profile.  For example, other variables that come into play include shape of chest wall on each side ( concave, convex, asymmetric…),  amount of breast/soft tissue coverage on each side, and/or quantity/quality/position of breast skin on chest wall on each side.I have found, on occasion, that despite pre-existing breast asymmetry, that the use of the same size/profile of breast implant achieves the best breast asymmetry possible;  this assessment is made after the use of temporary intraoperative sizers, careful measurements (dimensional planning), and viewing the patient's breasts in the upright position.If, in the longer term, you remain concerned about breast size, shape, or symmetry, best to address your concerns with your plastic surgeon or other board-certified plastic surgeons well-versed with revisionary breast surgery, in front of a full-length mirror. Working together, hopefully, you will be able to come up with a plan to improve your situation. Best wishes.

WIthout being in the OR the decision to use the same size implants was made by your surgeon. He is the only one to tell you why he chose the ones that he did.

Sorry to hear about your concerns.  Your original implants were 20 cc different (2/3 of an ounce), so they actually had a very similar volume. Silicone implants come in pre set sizes and sometimes the jump from one size to the next maybe 30 or 40 or even 50 cc.  So it is not surprising to try different sizes in surgery and decide that the best symmetry is with the same sized implant.  As far as your other concerns, it is best to address those with your surgeon as a physical exam is important and direct , in person evaluation gives the best answers. Shaped implants have some advantages but they can be stiffer, take longer to settle, and can sometimes rotate. Hang in there and keep your surgeon advised of all your concerns.  Best wishes,Below is a link to general information on breast revision.

Size of the implant is a judgment based on available breast tissue, and the differences in the skin envelop of each breast. Correction of asymmetry is a difficult issue, and you can ask you surgeon about the implant choice if you think there is a problem with your result.