Concern with Asymmetry?

I'm getting BA on Thursday 10/11 and am concerned that the BA will accentuate my existing minor asymmetry. I have one breast that is slightly smaller and higher than the other. I'm curious if I get silicone 350cc HP on one and 325cc HP on the other, will that help? Are the two sizes similar enough where I shouldn't be concerned with it looking uneven? Here are my specs if it's needed with this question: 5'2, 117lbs, pre-op 34A, want to be 34C.

Doctor Answers 9

Concerned with asymmetry

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I have never seen a woman with two perfecly symmetric breasts. The breasts after augmentation will still have minor asymmetries. I avoid different sized implants whenever i can.

New York Plastic Surgeon

Breast asymmetry

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Almost every woman I perform breast surgery on has some degree of pre-existing asymmetry.  Often, one nipple is in a slightly different location than the other.  It is important to be aware of this before surgery and also, that asymmetry will inevitably be present after surgery.  Although every attempt is made to achieve good symmetry with any breast surgery, it is not always possible.  

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Augmentation and asymmetry

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I have never seen a patient with the same two exact breasts. Minor asymmetry is the norm and I try to avoid different size implants if I can.

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

Augmentation and Asymmetry

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Every woman has a certain amount of breast asymmetry, and it's important that you understand that before your surgery--good job here. As a general part of my practice, I talk to patients about things surgery can fix, and things that can't be changed. Breast asymmetry is certainly something I address in discussing anatomical features that may still be present after surgery. Setting realistic expectations is important, and it sounds like you are already educating yourself. I do use different sized implants in surgery if  it's necessary to achieve a good result. One important factor to consider--more so than cup size--is base width. The base width of the breast, and the implant, differs along with the breast volume. Your plastic surgeon will assess this in your consultation and intraoperatively as part of achieving your best results.

Concern with Asymmetry?

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Asymmetry is always more apparant in a larger breast. The difference between each implant size is equivelant to two table spoons of liquid. Without seeing you or your photo's it is hard to judge. The best answer is to see your plastic surgean and discuss all your concerns.

Michael A. Fiorillo, MD
New York Plastic Surgeon
4.9 out of 5 stars 107 reviews

Concern with Asymmetry

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It is true that:

  • asymmetry is more noticeable on a larger breast
  • many patients are more aware of similar amounts of asymmetry after surgery than before

Without photos it is hard to answer your specific questions. We commonly use different size implants to try to get better symmetry. 

Because there are no fixed definitions of cup size, I avoid as much as possible the use of letters (B, C, D) as goals. 

Another pre-op discussion with your surgeon should help assure that both of you are on the same page. Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Breast Asymmetry

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I think it is great that you appreciate your asymmetry prior to your surgery. This is something that should be discussed between you and your surgeon because many of the asymmetrys that you have will be accentuated after the augmentation. Sometimes we as surgeons will make some intra-operative adjustments to the fold or nipple position but it can cause more harm than good. So you need to forget about implant size. That is not really a choice that you can make, you have to leave that trust to your surgeon that you have communicated your goals and that they understand your desires. The implant size is based on specific measurements that really only your implanting surgeon can choose. I do not really allow my patients to choose a number for what implant they want as far as how many cc's the implants are. It has little to do with that and more to do with the base diameter measurement of your breast. And by the way, the difference between 350 and 325 is literally nothing. It is the sip of the bottom of a cup and has little effect on cup size with such small increments of change. Let me discuss how to size a breast implant and breast for a moment. Bare with me. 

In my opinion these situations that we find ourselves in with patients can be simplified. Sizing is not about a number. In fact, I do not even discuss numbers with my patients. If a patient walks through the door and says they want x-cc implants I have to educate them about how sizing works. The best analogy I can relate this to is buying shoes. When you go to buy shoes how do you do that? First you start with the size your foot is right? So if your foot is a 6.5 you try on all kinds of 6.5 size shoes. Some may be tall, some might be flat, and some might be somewhere in between. You would never try to buy a size 8 shoe because it would be too big for your foot right? Breast sizing is the exact same way. Implants come in several different profiles that are like different heights of shoes. Implants can be low profile, moderate profile, or high profile. There are even implants that are higher than high. That would be your high platform shoe. Each implant style give you a different look. Now, your breast has a defined width that we call the base diameter of the breast. This would be analogous to the show size. Your breast base diameter never changes. It is what it is. So now, you can choose several different style of implants that fit the number of your breast base diameter. That really narrows down what implant is best for you. So once you know your breast base diameter you can try the low, moderate, high or really high implants on. The only thing you have to decide is which look you are going for. You would never put an implant that is 13 centimeters wide in a patient whose base diameter is 10 centimeters. Half the implant would be in the armpit. So, this is very simple to me. My patients get a few choices that fit their breast and that is it. I will not put an implant in a patient that is too wide for their body because it will harm them over time. Hope this helps.


Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Breast Asymmetry

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It is not possible to give you specific information without photos or an exam so, obviously, your best source of information is to discuss your concerns with your plastic surgeon.  In general, we can be reasonably successful in addressing volume differences between the two breasts by utilizing different volume implants although there is no way to precisely measure breast volume in the operating room so some asymmetry is likely to remain.  More challenging is to address asymmetries that involve fold, nipple areola or overall breast asymmetries.  While we do have techniques that are helpful you should be prepared for some amount of difference in appearance between the two breasts.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

Concerns about Breast Asymmetry before Breast Augmentation?

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Thank you for the question. 

Given your concern, you will be much better off  spending more time with your plastic surgeon discussing your existing asymmetry and the best way to improve your situation. This time spent will be more valuable than any online consultants'  advice, given the limited information available…

Given that you are aware of your breast  and/or chest while asymmetry better than anyone else, communicate your specific concerns carefully. Often, it is possible with the use of differential breast implant pocket dissection  and/or the use of different sizes/profiles of breast implants to improve the breast symmetry to some degree.

As you know, some breast asymmetry is more common than not;  the chances of achieving absolute symmetry is very small. Achieving realistic expectations prior to surgery will be important.

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.