Do I Need a Revision? My Right Upper Pole is Still Too High. (photo)

Hello, you have all been so helpful and I thank you for that. My question right breast seems to be dramatically larger and higher than my left breast. I am currently almost 10 weeks post op. It has been higher since the surgery and I have been massaging (selectively the R breast). Will a revision be required and/or help or do I still need to give it some time? I saw my PS a couple days ago and mentioned it but he didn't comment. Thank you!!

Doctor Answers 11

Asymmetry after breast augmentation--Here's a suggestion no one has mentioned!

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Aside from trying to decide if this is a mirror photo and which breast implant is lower, it's pretty clear that one implant is indeed lower than the other (you know which one, I'm sure), and the lower implant side is really as low as it should go. Any lower (and you can probably expect that as you are only 10 weeks post-op; full softening and settling can take 6 months or longer) and that side may actually "bottom out" too much and start to look bad.

While the "other" side (the higher-positioned implant breast) can also be expected to drop, at this point you are not doing anything to stop the low one from dropping further, and nothing to help the high one continue to drop so they can match better!

"Massage" is simply implant displacement exercises designed to keep a surgically-created slightly larger pocket larger via mechanical movement (rather than simply wearing an Ace bandage or surgical bra and getting a capsule the exact size of your implant, or hoping that muscular contraction with arm movement is "enough" to massage your pocket soft), but unless you displace one implant upwards and the other downwards, they will simply both "drop" essentially the same and always be asymmetrical, and eventually too low perhaps. I'd follow your surgeon's advice regarding "massage," but here's a suggestion:

Consider asking your surgeon if he can give you an elastic bandeau, and wear it below the lower implanted breast, and above the higher implanted breast, "Mexican gun belt" style. I recommend this to my patients who have this concern, ask them to do this only at night, and have them safety pin the bandeau to a T-shirt worn over the elastic band so it stays in proper position. Over a few weeks this may provide enough differential support to the low side and downward pressure to the high side to "even" things out, or at least move your result in the proper direction. Until healing is truly "complete" in 6-10 months, there is still every chance to actively affect your final implant positions.

Plus, it certainly is less costly than simply waiting for a re-operation! Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Asymmetric Breasts

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Hello Damsel,

I understand that the photo's images are reversed.  What is striking about your appearance in the photos, both after your first and your second surgery, is the the difference in your nipple to inframammary fold length.  Your left nipple is higher than your right, and it has a lot of skin between it and the left breast's inframammary fold.  This 'extra tissue'  is allowing the implant to 'settle in' to it's pocket easily and more completely.  On the right side, the nipple is lower, the skin is shorter, and the implant is sitting apparently too high.  This dissimilarity seems to have improved after the revision, however is still off.

Do not bother to message your breast as it is accomplishing nothing.  You will most likely need another revision, but you should wait a full 6 months.  You may consider seeing a few revision breast specialists to get an idea of how this can be rectified.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Breast Asymmetry after BAM

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I am confused, and I suggest you re-visit with your PS.


What I see is that your right implant is lower than your left implant.  By tradition, when doctors look at a picture, it is as if the patient is standing in front of us, so your right breast is on the left side of the picture above.


Anyway, the RIGHT implant is lower than the left, and in fact the lower pole and nipple also appears to be lower too.  I'm looking only at the right hand pic.


Revision surgery is in your future.  Timing is the next question.  My opinion is that if you can stand it, you would do better to wait until about 9 months to a year to allow for maximum settling.  That way, if any additional "adjustments" to the other breast needs to be done, it will be obvious, and can be handled at the same time.



Possible breast augmentation revision

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It will take a full 4-6 months to know for sure but it does look likely that you are heading for a revision unless things change dramatically.  One thing you don't mention and I can't tell from the photo is whether the creases below the breasts are level or not?  If not, they needed to be made level so the implants sat at the same level.

High Implant After Breast Augmentation

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   I would wait a little longer, perhaps even 6 months, before considering a revision.  That higher implant will probably drop a little more.  In addition, that same breast has a lower nipple areola complex and may need a circumareolar lift to help with ultimate symmetry.  Preoperative photos would be helpful in this regard.  Kenneth Hughes, MD Los Angeles, CA

Do I Need a Revision? My Right Upper Pole is Still Too High.

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Again a before posted photo would demonstrate the asymmetry you had prior. The result is very acceptable but for more evenness you will need further surgery if desired. 

Implant position after surgery

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i agree that the left implant looks high.    volume should be judged in a bra

the left implant can be lowered if not better after another month of massage . if it is firm  consider accolate or singular

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

After Breast Augmentation

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From the picture, I can't tell that the right breast is larger than the left. It does look like the right implant is lower than the left breast though.  I think you should wait the full three months that it takes for the swelling to be gone from your breasts before you decide if you need a revision surgery.  Be very straight forward with your surgeon about your concerns.  Good luck!

My Right Upper Pole is Still Too High

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I am not sure if this photo is taken in a mirror or not, but it looks like it is the left breast that is higher. !0 weeks is early to consider a revision for this modest level of asymmetry. Patience. Allow at least six months from surgery, and in the meantime, continue massage, and continue to follow up with your surgeon. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Time May Be On Your Side

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In the photos, it appears that the left breast is fuller on top with a slight downward orientation of the nipple.

If the breast creases are equal and you can feel the bottom of the implant at the crease, this may be a result of the left lower pole still being a bit tighter than the right. This may correct over time with the assistance of downward manipulation. 

A second surgery may be necessary if the crease heights are different or if downward manipulation fails to improve the situation.

Generally, I advise giving 3-6 months to see if the one breast "catches up": with the other.

Definitely ask your plastic surgeon about this.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 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.