Breast augmentation results are generally based on three variables. These are.1) the patient’s candidacy for the procedure. this should incorporate a clear understanding of different anatomic variance that can impact what the results will look like, including the distance between the breast, breast, divergence, breast, ptosis, breast, diameter, and other variables. ideally, that plastic surgeon should explain each individual person’s candidacy for the procedure so there are no misunderstandings or disappointments. 2) choosing the right implant in regards to size, type and shape. Implant selection is critical and delivering consistent quality results. Consistent with what patients were seeking. Each provider will have their own method of determining the right type of implant to use. The right provider should be able to guide patients through implant selection to minimize disappointment or outcomes that are significantly different than what was anticipated. 3) technically creating an accurate and correct implant pocket. To get quality outcomes, requires placing the implant in the correct anatomic position. Failure to do this may lead to need for revision surgery. Without having a clear understanding of who selected implant size or your surgeons ability to assess your candidacy, it’s difficult to make any judgments about your outcome. It does look like the implants were correctly, placed centrally under each breast. I suggest you follow up with your provider and discuss revision options with him or her. The following are some general guidelines for provider selection. To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider. There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery. Best, Mats Hagstrom, MD