What Can Be Done to Fix Uneven Breasts After Augmentation?

I am 4 months post op with 375cc saline implants under the muscle. At three months I was very happy with the results. At 3 and half months my left breast shifted down and towards the side. I know from my before picture that my left breast was a little lower and I know BA can make that more noticible. I went to see my PS and he of course said to wait until 6 months but I am very sad/frustrated and not sure if anything can be done to fix them. Please let me know what my options my be. Thank you.

Doctor Answers 28

Uneven Breasts after Augmentation Can Be Fixed

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question. Although you had Breast Asymmetry prior to your Breast Implants, the uneven Breast appearance has increased after Augmentation. This is common.

However, from your photos it appears that you have "bottomed out" slightly on the left compared to your early post op photos.

This Breast Implant Asymmetry can be corrected by an "Internal Capsulorraphy" which will reduce the size of the implant pocket and lift the implant.

It is best to wait at least 6 months for the implant to settle and the capsule to mature.



What Can Be Done to Fix Uneven Breasts After Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree that you may need a revision surgery to correct the asymmetry, however meanwhile, I would place you in a breast strap over the higher breast.  This may be effective enough to allow the higher breast capsule to strech and allow the implant to settle to a lower position.  If successful, you may not need another surgery.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Breast Asymmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, most patients have asymmetry prior to surgery and we as plastic surgeon's try our best to adjust for that and improve things if possible.  I perform lots of revisionary breast surgery and Although there is no scientific study regarding this situation, I like to wait 9-12 months before performing this type of revisionary breast surgery.  This time frame will allow for both implants to “settle” as much as they are going to (so that we see the final results) and it also allows for capsule formation that will be helpful in capsulorrhaphy (internal repair).  Make sure you have confidence in your surgeon and see many before and after photos of patients with the same problem.  Experience is key for revisionary breast surgery.

Breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Assymetry after breast augmentation is common and can frequently be corrected. Most women have assymtry between the breast but certain technical items can be performed to fix this. Usually it is advised to wait 6 months prior to a revision

David L. Abramson, MD
New York Plastic Surgeon

Be patient to see final breast implant results.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I do advise patients to wait 6 months to a year to see the final result.  Your breasts may not be done dropping. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast asymmetry after Breast Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi there-

I'm sorry you are not happy...

Improving your asymmetry is going to require another operation....

It is important to understand that even with a revision, you are likely going to have some visible asymmetry, so you need to think about how badly the asymmetry you have bothers you, and whether it is enough to consider having another operation to improve...

With regard to the timing, while I understand your desire to achieve maximum symmetry right away, I would agree with your surgeon that your chances of achieving the best outcome possible increase the longer you wait (up to about 6 months).

Asymmetric breast before and after breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are correct that you had asymmetric breasts prior to breast augmentation.  Unfortunately. that asymmetry gets augmented after breast augmentation.  If you are really unhappy with the asymmetry/result, you need to undergo a revisional surgery.  The options will be 1)Lowering of the IMF on the right  or 2) Getting periareolar or circumareolar breast lift on the left.  However, this is another surgery and you may have a new scar on the left breast.  Even after the revision surgery, you will always have some degree of asymmetry between the right and left breast.  Please remember that all women have a slight asymmetry in our breasts.

Breast Asymmetry: To Fix or Not To Fix? (and When?)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are right to note that you had an asymmetry preop and that implants can make the natural asymmetry more noticeable.

All of us who perform breast augmentation face the challenges you present. The answers and possible solutions are very individualized.

How to decide whether to try to improve an asymmetry?

  1. Does it bother you enough to warrant an operation?
    1. Does the asymmetry show when you are dressed?
    2. Does the asymmetry show in swimwear?
    3. Even if concealed in clothing, does it make you self-conscious when naked?
  2. Will surgery reliably make enough of a difference?
    1. Risk/benefit
    2. Cost/benefit
  3. Which technique?
    1. Raise the left or drop the right?
    2. Tighten the lower pocket with sutures or use of allograft (graft from a tissue donor bank) for support?

When to do a revision or asymmetry repair?

The answers can't be easily simplified in an on-line inquiry. Your surgeon's professional judgment is a valuable resource to you and you should stay in close contact with him/her and openly express your concerns.

Second opinion is an option to consider and can be very reassuring, but, as you can see from the different opinions expressed here, experts may disagree.

In general, time is on your side in that the problems you see do not require emergency intervention. Many plastic surgeons will consider a 6 month time frame in evaluating implant position issues after a breast augmentation.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

What Can Be Done to Fix Uneven Breasts After Augmentation?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Kat66, You are correct. You had some asymmetry prior to your augmentation and the appearance is now more noticeable with larger breasts. It looks from your photo your entire left side of your body dips lower, starting at your shoulder. That being said, it does appear your left side has bottomed out slightly. The implant may have been positioned too low on the chest wall in relation to the nipple position. Or it sometimes happens due to over dissection of the pocket in the region of the inframammary crease (breast fold) or cutting of the lower portion of the pectoralis muscle during surgery. It also can occur naturally with implants that are placed above the muscle.This can be repaired, but your surgeon is correct, you do need to wait a bit longer. Good luck.

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Fixing Uneven Breasts After Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Although it is common for breasts to be uneven as they heal from an #augmentation, #asymmetry is among the reasons some elect revision surgery. However, depending on the reason or cause for asymmetry will determine the surgical technique applied. Also, there is no guarentee that one revision surgery will correct the asymmetry. For instance, any asymmetries regarding the folds under your breasts will not be totally corrected. Additional elective cosmetic #surgery is a personal choice. Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision. Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 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.