My breasts are too far apart and different sizes! How can this be corrected? (photos)

Posted before but appear visibly worse. Had 400cc motiva round high profile silicone implants under the muscle in nov 15. From 34b to 34dd in right breast & d cup in left breast. Breast moving further apart over time & almost fall off my chest when I lay down causing a little discomfort. Right breast larger & lower (it wasn't pre op) fullness mainly in lower breast. Not much upper fullness in either breast. Upsetting as noticeable in & out of bra.

Doctor Answers 9

Position/Size Concerns

Hello,
Thank you for your question and photos. comparison with pre photos would be required to note pre op asymmetries. Lateral displacement could be addressed with a revision surgery if necessary. You will need to see your Plastic Surgeon in person for an exam and discussion of options.
All the best

Wider Cleavage

As many of the other surgeons have answered it is best to have an in person consultation as photos can be deceiving. Before photos are always key in noting what the surgeon could and could not do with your natural anatomy. Everyone has a different body type and shape. You may have started out with wider cleavage where your surgeon could not give you the touching or close to touching cleavage look without the use of a bra. In most cases if your surgeon were to go outside of your natural cleavage for the implants to sit closer you can get what is called symmatstia (uni-boob). Which can be a difficult fix. 
As your post-op photos show your right breast seems to be bottoming out (mal-positioned)  which causes it to be lower than your left. Also noted both implants to be falling to the side as time progresses as well. There is no harm in having this happen, but it can cause some pressure on your nerves that can cause you discomfort. This is fixable with a procedure known as a capsulorrhaphy. That said procedure is where your surgeon closes down the implant pocket with suture to ensure the implant is properly placed. You may also want to consider switching to a textured and higher profile implant to give you a fuller look on top. Most patients in my practice who want a lot of fullness up top without a bra on usually get Allergan Inspira SRX implants. These are the "over filled" silicone implants that give you a more round, projected and fuller look. I would contact your Board Certified Plastic Surgeon and have a follow up appointment to assess the possibilities of obtaining the look you are wanting. Make sure he/she really knows what you are wanting, so you are not upset with your results. Also be sure to understand what is achievable and what is not based on your own natural anatomy. 

**"The above answer posted has been given without seeing this patient and cannot be substituted for an actual in-person examination/consultation with a medical professional and professional advice; it is only opinion based on photos and/or description of symptoms. Seek in-person treatment with a trained BCPS medical professional for appropriate action and care to be given."**

J. Dayne Petersen, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 20 reviews

Cleavage

Your cleavage is determined by your underlying anatomy. Sometimes a capsule revision can improve lateralization of implants. An exam in person is key.  

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast Augmentation Asymmetry

Without a consultation, examination, and pre-operative pictures, it is difficult to give you sound medical advice. In general, high profile implants give less superior fullness. It is possible that the right breast implant is lower than the left breast implant. Best wishes!

George C. Peck, Jr, MD
West Orange Plastic Surgeon
5.0 out of 5 stars 21 reviews

Need Pre-op photos

I understand and see what you are talking about.  It would be great to have a preoperative photograph to see what the surgeon started out with.  Without a consultation and knowing your chest measurements as well as the implant placed, any internet consultation would be purely conjecture.

My breasts are too far apart and different sizes! How can this be corrected?

I am sorry to hear about your concerns after breast augmentation surgery. You demonstrate and describe your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients.  This phenomenon is called lateral displacement of the breast implant;  it may be of concern from the visual and the discomfort standpoints. Surgical correction is an option (and given your concerns, will likely be necessary).

Generally, the lateral breast implant (and/or bottoming out) displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline.   In my practice, I use a 2  layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option (although not usually necessary)  especially if significant implant rippling/palpability is present.  

I hope this, and the attached link and video (dedicated to this type of revisionary breast surgery concerns), helps.  Best wishes.  

Malposition of implants

Simply viewing your photographs it appears your implants are too low and lateral. This can be corrected with revision surgery to reposition the implants and possible change the implant size on one side to achieve better symmetry.

Eric E. Wegener, MD
Jackson Plastic Surgeon
5.0 out of 5 stars 6 reviews

My breasts are too far apart and different sizes! How can this be corrected?

Thank you for your question. I would recommend speaking to your surgeon about your concerns. Ensure that you always see a board certified plastic surgeon. An in-person assessment is always best. 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Breast lift and Implants

Thank you for your question and photos. I am sorry that you are unhappy with your result. Based on your photos, it appears that you have significantly bottomed out and that you lack lateral support. The position of the scars indicate that the implants have dropped below the normal inframammary fold. In order to get improvement, the implants need to be repositioned superiorly and the pockets tightened laterally. Sometimes, this can be done with capsular tightening, in which the scar capsule laterally and inferiorly is sewn to the chest wall to create a better support. If the capsule is very thin however, you may require support with Alloderm or SERI mesh. This is a fixable problem however it would be best to consult with a board-certified plastic surgeon who has experience in revisions. Best of luck.

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.