Correcting Breast Asymmetry After Implants with Superior Crescent Mastopexy? (photo)

hi before having breast implants for correcting mild asymmetry and one breast siting lower i put some of my concerns here so i did go on with the doctor decision ,290 cc in the one siting lower and more empty and 265 in the other one it is been 10 months and my breast are more uneven now the doctor is sugesting to perform a superior crescent mastopexy on the lower siting breast is this a good idea in my case or i should go for a full lift ?

Doctor Answers 9

Breast Asymmetry Pre-Op and Post-Op

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   Dear Maniliza,

      I would agree with most of my colleagues, and suggest a circumferential mastopexy. I have found the superior crescent lifts to be of little use and rarely use them in my practice. You have more ptosis on the right breast and it appears that there may still be a volume difference as well. An exam would help me decide if a smaller implant on the right or a larger implant on the left is needed. This would be your decision. Keep in mind that "perfect symmetry" may/will not be possible and having a lift on one breast and not the other may/will add to the asymmetric look. Be sure to ask to see photos and discuss all options with your surgeon before you proceed. Good luck.


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Thank you for your question and for the photos.

The problem that you see now in the after photos is due to the size and shape of the right breast before surgery.  The right implant is sitting lower because there is more skin on the right breast.  If you were to measure the distance from the nipple to the inframammary fold you would find that it is longer on the right than the left and it was before surgery as well.  This skin, after the breast augmentation has stretched more than the skin on the left side so the right implant sits lower and accounts for this difference.

I may be simplifying things by saying skin but there is also more body fat and breast tissue. A crescent lift will only cause a small change in position of the nipple and will not address this problem.  Tightening the internal capsule will not unfortunately address the problem either.  The skin and breast tissue of the lower part of the breast needs to be tightened by performing a breastlift or mastopexy using a circumvertical approach.  That operation will leave a scar around the areola and vertically downward to the fold under the breast.  In my opinion, it is best to do the same operation on both sides, just a modified version on your left side in order to have the greatest symmetry.

Crescent mastopexy will not correct the breast implant assymetry

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A superior crescent mastopexy is designed to raise the upper border of the areola higher.  The procedure is rarely performed since it has few indications.  A purse-string mastopexy with a permanent suture, on the other hand, is a useful procedure to lift or reduce an areola.  In your case, your asymmetry is caused by a lower sitting implant on one side compared to the other.  If your breasts feel like they are about the same size and you like your size I would recommend an inferior capsullorhaphy (tightening the pocket on the lower sitting breast) and possible a purse-string mastopexy on one or both sides for symmetry.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

Superior crescent lift

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I am not a big fan of a superior crescent lift. I prefer a circumareola so that the entire areola is treated evenly.

Uneven breasts after augmentation

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Looking at your pre-op photos, your result seemed predictable. Your right breast was not just bigger, it was drooping more than the left. Simply placing breast implants of different volumes is not the solution. It looks like you needed a lift on the right breast at the time of the placement of implants. You need a revisional surgery that includes a mastopexy on the right...the procedure you needed originally.

Correcting Breast Asymmetry After Implants with Superior Crescent Mastopexy?

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In my opinion based upon the series of photos I would increase the size of the left and do l-shaped skin only mastopexy on right. Best to be seen in person

Revision army breast surgery

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In my experience, crescenteric mastopexy seems like a good idea, but really does not provide much lift, especially in large breasts.  Your right areola is already larger and more elongated than your left.  A cresenteric mastopexy will distort your areola more without enough lift for the size of your breasts.  A periareolar mastopexy with a scar that goes around the areola will provide a much better solution to your asymmetry.  Ask to see before and after photos before making a decision.

Leonard T. Yu, MD
Maui Plastic Surgeon

Best Option for Revisionary Breast Surgery?

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Thank you for the question and pictures.

I have the same concerns that you do that a “superior crescent mastopexy” on the more ptopic breast will not provide enough of a breast lift to improve symmetry and/or achieve your goals. I also think that the crescent breast lift in general provides very minimal breast lifting and can lead to an elongation/distorted appearance of the areola involved.

I would suggest that you communicate your goals and your concerns clearly with your plastic surgeon. If still in doubt, seek second opinions in person.

Best wishes.

Crescent Mastopexy/Lifts Give limited results.

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A Crescent mastopexy is the least effective of all the lifts to correct asymmetry. For that reason I would recommend a periareolar mastopexy (scar goes completely around the areola not just on top). This will allow you to correct the nipple position for more symmetry. What it will not do however is correct the size difference nor the location of your infra-mammary crease which is lower on the left. 

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.