5 years post breast augmentation - what can be done to achieve more symmetry? (photos)

Hi. Based on your preoperative photograph I would have recommended a breast lift in addition to breast implants. You do have some asymmetry (as do most women) with your breasts before you had surgery. As mentioned in one of the other answers, this is often times amplified after placement of breast implants. Based on just the pictures I see I would certainly recommend a breast lift (mastopexy) and possibly swapping out for a smaller size depending on your preference in that realm. Personally, I would not recommend going larger because of the stress on the tissues etc. I would recommend consulting with a board certified plastic surgeon with good experience with breast surgery and who specifically also has good experience with breast revision including augmentation mastopexy.
Good luck and take care,
Dr. Howell

Dear nels94,breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You would benefit from a lift along with smaller implants. You had asymmetry prior to your implants and that gets exaggerated when you have implants placed.

From the submitted photos it appears the breast tissue is now sloped over the implant. A lift is needed to improve both shape and symmetry. It appears from your pre op photo that a lift was needed from the beginning.

You needed a lift in 2018 and still need a lift. Getting large implants does not change that a lift is still needed.