Do I need revision if my breasts are not symmetrical at the 3 to 6 month period? Thanks! (Photos)

I had my saline implants done 65 days ago. My PS and I agreed to 325cc but he chose 270cc and overfilled them with 325cc and on my card it said that was the "final fill volume." Can my PS add more cc on my current saline implants so that he can make my breasts symmetrical or am I going to need new implants? Would I will need a release of your left breast pocket since it's too high so it can reposition the mound lower? How would you personally handle this situation? What do I need done?

Doctor Answers 9

Overfill and Final Results

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Hello. You have two questions. 

First, I teach my patients there are different "fill" volumes. It really depends on the RANGE of your implants. Most 270cc will fill only to 300. Check on this. There is minimal fill volume and optimal fill volume (the range of the implant) then overfill. The latter almost always leads to rippling so i never overfill beyond the maximum (optimum) fill. Some implants with a broad range of fill volume i fill to the mid range.

Second, at 65 days you are still early to see some aspects of your final result, including a high riding implant like on your left. Your volumes and size will not change. I teach patients to use the foam roller exercises combined with ultrasound to lower implants at your time interval and it works. We can send you a diagram of such exercises if you like.

San Francisco Plastic Surgeon

I avoid size issues by having my patients choose what they will have prior

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and that is what they get... I don't change things on the table.  Usually such changes are supposed to be done to get better outcomes and is usually covered in the consent you signed.  Now that you have an appreciable asymmetry from using equal volumes that was determined by your surgeon, you simply have to ask your surgeon if he/she is happy with your outcome.  Ethical and honest surgeons should acknowledge your concerns and then you should focus on finding solutions that will help you and improve the outcome.  You cannot rush into this... give yourself at least 6 months before having a revision and this allows for a clear plan regarding size, pocket, etc so there is no more miscommunication.  Know what your surgeon's revision policy is so you know what you're looking at in terms of costs to you.  And if your surgeon says you look great (as you are right now), you just chose a bad surgeon and will have to get a second opinion from a reputable, board certified plastic surgeon.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast revision after augmentation

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Thank you for your question and for sharing your photos. Did your breasts look like this immediately after surgery? The left breast appears smaller and higher, is it also firmer than the right? You may have started to develop a capsular contracture on the left. I would strongly recommend that you visit with your surgeon and have your surgeon carefully examine you. If you will need revision, you will likely need implants exchange and some capsule work. Your right breast, if you are happy with it, does not need to be operated on. Good luck.


Olga Bachilo, MD

Do I need revision if my breasts are not symmetrical at the 3 to 6 month period?

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As you seem to be aware you are early in the healing process and there is the possibility of your left high breast implant dropping into position.  I suspect that you had significant asymmetry of your breast before the procedure and as best as I can tell from the photographs it appears the left breast remains smaller than your right.  If the implant does not settle and your asymmetry remains present, I think you will need repositioning of your implant and possibly replacement with a larger implant on the left.  Allow further time for healing and discuss your options with your surgeon or if you seek a second opinion be sure to see an ABPS board-certified doctor.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews


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Have you spoke to your surgeon about these changes? Did it look like this after surgery?  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).
Dr. Desai
Beverly Hills Institute for Aesthetic Plastic Surgery
Harvard Educated, Beverly Hills & Miami Beach Trained
Double Board-Certified Beverly Hills Plastic Surgeon

Do I need revision if my breasts are not symmetrical at the 3 to 6 month period?

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We can't get all the information we need from the photos, but it does look like you will need a revision to get better symmetry, including the lowering of the left implant.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breasts asymmetry

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Dear N1111,

it is hard to tell without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD, MHA, MS 

Certified, American Board of Plastic Surgery  

Member, Am. Society of Plastic Surgery

Daniel Barrett, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 85 reviews

Breast not symmetrical?

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From your photos your breasts do appear to be asymmetric. Much of this is due to the fact that your left implant is still too high and has not filled out the lower pole of your breast. If your breasts were not symmetric before surgery they will not be symmetric after surgery, particularly if the implant fill was not adjusted to compensate for any pre-existing asymmetry.

You should ask your surgeon about superior pole massage on the left side to see if you can get that implant to settle further. If after 6 months the implant is still too high it can be surgically repositioned.

Asymmetric Breasts

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This is not an issue with size, it is an issue with asymmetric implant position on your chest wall fooling your eyes into thinking one is bigger than the other. If your surgeon isn't an ABPS certified/ASAPS member surgeon who specializes in revision breast surgery, you should find someone who does. If it is determined that you'll need a surgery, it will be a good time to remove the saline implants which are already too over filled and replace with silicone gel implants. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 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.