11 months post op - what could be causing the my right breast to appear so different from the left? (photos)

Question

Can anyone help me I had my boobs done last October and my right boob isn’t as full on the outer edge as the other one is round , looking at it face on my right breast as gone bent does anyone know what this could be I have uploaded when I first had them done to out they have done over the months

Semih Yildiz, MD, FEPOBRAS · Answer

At 11 months, a persistent or changing difference in breast shape can come from several things: the implant pocket position, settling differences, capsular contracture, lateral displacement, bottoming out, implant rotation if a shaped implant was used, or your natural breast asymmetry becoming more visible. In the visible photo, there appears to be a difference in breast contour and outer fullness, but photos alone cannot identify the exact cause.

The best next step is an in-person review with your operating surgeon or another board-certified plastic surgeon. They can compare your early and current photos, examine the breasts standing and lying down, check implant position and firmness, and decide whether imaging is needed. Revision treatment, if needed, depends on the cause and may involve pocket repair, implant adjustment, capsule work, or a lift, but it is better not to choose a plan until the anatomy has been examined.

Carlos Marciales, MD · Answer

Hello, thank you for asking, it could be several things, but to be sure you should go to your doctor, it could be that the implant turned over, it could be a capsular contracture, and many more things, but an in-person evaluation is needed to determine the problem.

Stanley Castor, MD · Answer

Hi Surraya,
It looks like you maybe developing capsular contracture on the right breast. This is a scar tissue capsule that forms around the implant and give the breast a squeezed appearance with flattening on the sides. The capsule can also push the right implant up higher making it look different. The breast can feel more firm than the other side. I would recommend you see your plastic surgeon for an in-person exam to determine if capsular contracture is the problem.

Miguel Mota, MD · Answer

It seems like a probable capsular contraction. The pocket looked a little tight on the outer breast since the begging. The implants usually settle and resolve this issue but due to the capsular contraction this did not happen in your case. Unfortunately you need a pocket revision surgery. The entire pocket needs to be revised making sufre the outer edges are released.

Best of luck,
Dr, Miguel Mota

Best of luck,
Dr, Miguel Mota

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and pictures, but without an exam it is hard to know for sure. My concern is that you may have early capsular contracture, folding of the implant, or if you have a shaped tear drop implant that may have rotated.  In either case, please go visit your plastic surgeon, good luck.

Connie Hiers, MD, FACS · Answer

You have a capsule that is pushing the breast up and in some so that it is not round. You could try oral Accolate and external ultrasound treatments to see if this improves. Otherwise, you will need surgery to release the capsule. Stop wearing bras that push your breasts inward and upward.

Camille Cash, MD · Answer

From the photos it may be you are developing capsular contracture.  All implants have a scar capsule that forms around them.  For some patients this capsule may thicken or tighten around the implant.  This can make the breast feel firm, distort, or even hurt.  Visit with your surgeon for an evaluation to learn more.  I've included a video on capsular contracture that I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

To make a quality assessment regarding the outcome of any plastic surgery procedure we usually need to see a complete set of proper before and after pictures.
If you don’t have before pictures, then ask your surgeon to forward the pictures they took.
Your right breast has significant divergent.
This means instead of pointing straight forward, eight points out towards the side.
 Lots of women have a breast divergence and this usually makes it easier to breast-feed after pregnancy.
When women have breast divergence, the surgeon can either put the implant so it’s centered under the nipple or put the implant in what most people would consider ideal cleavage position. that is what your surgeon did.
He put the implant in where the ideal breast position should be. 
That however, is not where your breast sits.
Your breast sits more laterally to that and if your surgeon put the implant so it was centered on your nipple it would sit out towards the side and not give you the midline cleavage.
Personally, I believe the implant should be centered on the nipple, but doing that will leave patients complaining that the implants sit too far apart sometimes.
 When women have breast divergence, you can have one, but not the other. Either the implant sits in the ideal breast position or the implant is centered on the breast. Obviously, somewhere in the middle as an option as well.
This should’ve been discussed during your in person consultation before you had surgery.
It’s definitely possible to open up the pocket towards the lateral side, but recognize that doing that will remove the midline cleavage to some degree.
The bigger the implants are the more divergence becomes an issue.
Divergence is put on display with the projection of breast implants.
Best,
Mats Hagstrom MD
P.S.
I just went back and looked at your previous post that included preoperative pictures.
Seeing your preoperative pictures helps a lot.
Your breast sit far apart on your chest wall, and your surgeon tried to bring him in towards the midline significantly.
Part of the lift that was done on the right side was not just lift the breast upward, but towards the midline.
Considering where you started and what your baseline candidacy was for the procedure your outcome is actually quite good.
Your candidacy for equality outcome. It was a little bit limited and I think your surgeon did a pretty good job for you.
Some providers have brought up the possibility of having a capsular contraction on the right hand side.
It would be important to get an assessment for this, which your surgeon should be able to help you with.
With a cap or contraction you begin to feel the implant as being a bit firm.
 Really bad cap contraction would feel like a tennis ball underneath your skin.
Overall, I think your outcome is actually quite good because I think the were some inherent limitations to start with.

11 months post op - what could be causing the my right breast to appear so different from the left? (photos)

Answers (8)

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