Should I get the same size implant in both breasts? (Photo)

Is there any visible asymmetry in my breasts? I am planning on getting 475cc implants but I'm worried that after surgery one might be bigger than the other. And would 475cc be big enough to achieve my desired look ? Thanks :)

Doctor Answers 11

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question. The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.   Silicone will give you a fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion. Anatomic gummy bear implants might be a good choice to give you volume. These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak. During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon #RealSelf100Surgeon #RealSelfCORESurgeon

Asymmetry

Hello, thanks for your pictures and for your inquiry. I would say that your asymmetry is hardly noticeable in the picture, an in person consultation would be a must. You can still have the desired look with the same implants in both breasts.  Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!
Respectfully,
Dr. Jaime Campos-Leon
Board Certified Plastic Surgeon

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 243 reviews

Implant Selection

Thanks for your question and photos.  I tell patients all the time, 'As it turns out, God doesn't do symmetry.'  He really doesn't.  The size discrepancy in your case is not significant and could be addressed with slightly different sized implants if that is your concern.  If it is not, don't worry about it.  My greater interest would be in achieving medial fullness for you because there is a fairly good sized midline separation between your breasts.  This can be improved to achieve medial fullness or increased cleavage with care taken to perform adequate pocket dissection medially.  You should discuss this point with your surgeon to ensure you are aligned with your expectations.

Is there asymmetry.

My tongue in cheek answer would be that if you don't see any asymmetry then I wouldn't worry about it.  It's difficult to say definitively via just your photos.  Most women have a small degree of asymmetry and if you don't notice yours now then using the same size implants would likely be the right choice for you.  Is the 475 cc large enough?  I'd say that sounds about right comparing your current photos to the wish pics.  To get the tight cleavage and high roundness you might consider going over the muscle rather than under.  You've got wide restricted area at low medial breast which would fill out nicely with implants above the muscle or full release of inferior pec insertions if staying under the muscle.  Best wishes!

Levi J. Young, MD
Overland Park Plastic Surgeon
5.0 out of 5 stars 44 reviews

Should I get the same size implant in both breasts?

The "simple" answer to your question is that I decide during surgery whether the side that is smaller in volume and which also has less skin can be expanded to accept a slightly larger implant than the other side.  Such expansion is made easier if the patient has had one or more pregnancies or major shifts in weight in the past. If not however then placing similar sized implants may be the best approach.  85% of women have asymmetries in their breasts and you must expect this because placement of an implant will not magically equalize both volume and skin surface as well as breast position. It simply makes each breast larger.
I also note that your nipples are in a wide position on your chest and that the curvature of your ribs will tend to make your implants fall to the side precluding creation of a narrow cleavage as you show in your last picture.  Bra support or a bathing suit top should help enhance your cleavage but you must be aware of the limitations of the surgical procedure with anatomy such as yours.  Nonetheless I would encourage you to go ahead with your surgery but be careful to avoid too large an implant due to the higher risk of complications.  Good luck and best wishes.Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Should I get the same size implant in both breasts?

Thank you for your question.  It is important to understand that 88% women  have asymmetrical breasts.  You have normal asymmetry in that your right breast is lower and larger than your left breast.  It is important to discuss this asymmetry with your plastic surgeon and ask if different sized implants may be used.  The size you have chosen is quite large and should increase your cup size by a factor of almost 3 in the same style and manufacture of bra that you currently wear.  For more on asymmetry please read the link below:

Should I get the same size implant in both breasts?

From the photos oone side looks slightly larger but not by much. If you can't even tell, since you are asking the question, you should probably use identical implant sizes. no one has perfect symmetry. To answer the second part of your question, choosing the right implant size for a patient requires an exam, but no matter what implant size, you are not going to get the closeness of breasts seen in the model because your anatomy will not allow it. Your natural gap is too wide. Without realistic expectations you are certain to be disappointed in any surgical results.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Your breasts are "sisters" not "identical twins"

It is important for any surgical candidates to understand that absolute symmetry is a myth. Nobody is absolutely symmetric. If the asymmetry is significant the patient may be aware of it, however, in many instances I can appreciate a difference on exam that the patient is not aware of. If you are asymmetric pre-op, you will be asymmetric post op (unless something is specifically done to address the difference). A good rule of thumb regarding the search for symmetry is that it is not worth pursuing if the patient was unaware of it pre-op (i.e. if it was not a concern before don't let it influence your operative plan). A thorough consultation should include a careful examination and assessment of these inherent differences so that informed decisions can be made. Generally, after augmentation, a perceived difference will actually be lessened as a volume percentage but may seem more significant in the critical eyes of a post-op patient. It's like identifying a flaw  in a magnified photo.In those patients where there is an asymmetry (that is deemed worthy of correction) different size implants can be helpful. For more subtle differences, patients can consider saline implants with differential filling as this offers more flexibility.Based upon your photos alone, there is a slight difference in volume (which may be smaller than the sizing interval involved in an upsize).As always, discuss your concerns with a board certified plastic surgeon.

Donovan Rosas, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  I would use the same size for you.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 78 reviews

Avoid different size implants

I always try to avoid different sized implants unless there is a severe difference. My thinking is that with two different sized implants many life events that occur will recreate the difference between the breasts (pregnancy, post-partum, weight gain or loss, menopause). Another thing to consider is the mathematics; If you have a 10% difference between the breasts and you double the size of the breasts with implants the difference becomes 5%. If there is a moderate difference, I liposuction the larger breast so I can use identical implants.

Donald W. Kress, MD, FACS
Frederick Plastic Surgeon
4.1 out of 5 stars 12 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.