Can I Use Two Different Breast Implant Profiles to Correct Natural Asymmetry?

So you are aware that no one is perfectly symmetrical before or after implant surgery, as has been pointed out in the previous replies. However we very often use different implant sizes and profiles when the degree of asymmetry is significant. The first goal is to try and get the volume difference corrected, and then try to have the implants match in base diameter. This will mean the they will be different profiles. Saline implants have the option of being adjustable for better fine-tuning the volume difference.

SEE VIDEOS BELOW TO UNDERSTAND BREAST ASYMMETRY. This is not a normal practice but it is often the best method to achieve a result with the least amount of surgery. Alternatively you could undergo reduction of the larger breast with placement of similar sized implants but that will likely require more surgery, possibly more scars and more risk. I have always said it is best to "expect less asymmetry rather than symmetry" and you will generally not be disappointed. Any asymmetry procedure carries a higher risk of revisionary surgery in order to achieve an optimal result. 

 I have created a series of 4 youtube videos discussing some of the aspects of breast asymmetry. These are my opinions and demonstrate several different results if you take the time to review.

This is a difficult problem and a very good question. 

The problem is that asymmetry is usually both shape and volume and can even be position of the breast. Simple volume difference in implants rarely solves it and an even bigger problem is that we have no good or simple way to measure breast volume. We know the volume of the implant but not the breast. It is also not very helpful, in my opinion, to use external sizers to try to judge the correct volume although it may be of some help in volume difference between breasts. Sitting the patient up during the procedure is also not reliably accurate. 

Small differences in breast volume can be handled well with the 10% fill difference in the same size saline-filled implant. There is no way to do this with pre-filled gel implants. A larger implant will also be wider and the width of the implant generally needs to be the same for symmetric breasts. If the width of the implant is the same then the next step up is different profiles which can give about a half cup size difference in size increase (or as much as a full cup size different from a low profile to a high profile). This is reasonably straightforward except when shape is different and volume of the breast is not easily measured. 

My approach is to judge the degree of volume difference in cup sizes preoperatively (and address the shape issue separately), measure the width of the breast to find out what width implant will fit, and then use the profile (and fill in saline implants) to compensate for the volume difference. 

It is also important to point out that breasts with significantly different volumes will also age and respond to weight changes differently such that almost all such patients will likely need an adjustment in breast implant volumes later on even aside from the shape changes. 

It is very common for women to have asymmetric breasts, even 1-2 cup size differences.  Our goal as plastic surgeons is to lessen the asymmetry with different implants (bigger implant in the smaller breast) to make it less noticeable.  This, however, will never fully correct the difference/asymmetry.  The reason being is that the larger implant is in the smaller breast and will have more of an "implant" look.  The larger breast with the smaller implant will tend to have a more natural look.

If the volume difference is sufficiently large, then it is often common practice to use different profile of implants to ensure that the base width of your breasts is respected.  Communicate with your surgeon, but it seems that this could be a reasonable approach for the correction of breast asymmetry.

Best of luck

Vincent Marin, MD, FACS

La Jolla Plastic Surgeon

By the information you have given it sounds like the plan is very appropriate.  Every woman has a certain degree of asymmetry and it is not uncommon to use implants of different volume and or profile shape.  You need to realize that no one can achieve exact symmetry but the implants are meant to improve your existing asymmetry.

Best Wishes.

Very few women have perfectly symmetrical breasts. NOTHING is symmetrical in nature. Our eyes, our cheeks, our buttocks, our limbs - they may be close but never perfectly symmetrical. The overwhelming majority of women are NOT aware of asymmetry until it is pointed out to them photographically. When they ARE aware of it, the asymmetry is significant.

Correction of Breast Asymmetry in Breast Augmentation is a challenge that can rarely be achieved. The best that we can do is narrow or improve the asymmetry. This can be done by using temporary OR implants or sizers which guide us as to which implants may best be used. The options are
1. Reduce the large side to the size of the smaller breast.
2. Augment the smaller breast to the allowed / desired volume and then with sizers pick the (smaller) implant required to augment the larger breast.

Dealing with breast asymmetry can be tricky.  While I am not a big fan of using two different styles of implants in the majority of people, sometimes you have to if there is a large difference between the breasts.  Remember that they will never be exactly the same.

The answer is "it depends."  Breast asymmetry is quite common, and may come from differences in the amount of skin you have, differences in the location of your breasts on your chest wall, legnth of your breasts, and then the actual amount of tissue within the breast.

Implants of differing sizes or profiles may help if you truly have more breast tissue in one breast than the other, but implants alone will not do too much for any of the other factors I listed.

Other techniques like lifting are sometimes needed if there are large differences in the breasts.