I'm going to be getting a saline implant (sub pectoral) in my left breast and I'm concerned about the symmetry. (photo)

Thanks for your question. As several surgeons have stated, you have both volume and positional asymmetry. An implant alone will only improve the volume asymmetry. A lift of the right breast will correct the positional asymmetry. Given your full (youthful) right breast, a unilateral left augmentation should nicely correct the volume asymmetry (although I have also done both sides in this situation before with  asymmetric implants  - really depends on tissues and your size preference). Also, please consider silicone implants for the best result. Even though you are under 22 (the age below which we are supposed to use saline only), the right lift qualifies this as a "reconstructive" surgery in the eyes of the manufacturers and allows use of silicone. Most importantly, seek out a reputable board certified plastic surgeon in your area. Good luck!

Your
photograph shows asymmetry of volume and position. Implants alone just change volume. In order to create symmetry, you will need
both breasts operated on to correct the shape and position. I recommend a new technique called Breast
Augmentation with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage. The symmetry can be corrected and implants
placed. Aligning the areola, breast
tissue and implant over the bony prominence of the chest wall maximizes
anterior projection with a minimal size implant. For your volume asymmetry, you only need an
implant on the left side. At size 36
each 200 cc’s of implant corresponds to 1 cup size change. If your right side is a C and the left side is
an A then approximately 400 cc implants would be required to correct the left
side. Best Wishes,Gary Horndeski, M.D.

Dear Tess,   Thanks for submitting you picture. From the picture I observed the followings : 1. Left breast is about 1 size smaller than right breast . 2. Left breast is about, very small A cup and right breast is about A+ cup 3. Right breast is is droopy and the the areola is larger and displaced more lateraly than left breast. 4. Wide cleavage. Well, you have a good start by having saline implants because they make the correction of the asymmetry much easier and the subareola incision enables much nicer cleavage formation and crease positioning. It is extrememly important that your surgeon is experienced and comfortable with the mini lift procedure, which enables the right nipple to be elvated and moved medially as well as reducing the size of the areola. That will help dramatically to achieve symmetry. Since you are 36 very small A cup on the left side , to become a 36 C cup you will need roughly a volume of 475 cc . On the righ side you will need a volume 300 cc . Obviously, you will have to be measured accurately by your surgeon. Always, consult with board certified plastic surgeons and check their before and after pictures to make sure that you like their results. Also , make sure that the pictures are numerous and consistent and that the surgeons have good reviews.                           All the best,                                               Dr Widder

Truthfully, you have received excellent answers from the other doctors so far. You do, however, have options that have not been discussed.An implant in one side only will give you breasts that are much more symmetric than they are before surgery. In clothing and swimsuits you, should look excellent. Without clothing, you will have some asymmetry. This should actually be minimal in my opinion, and it is natural to have slightly different breasts.An important option for you is doing a lift "IN THE FUTURE" if you don't like the asymmetry, or its more than you wanted. You can always do the lift later! This is important to understand even though most woman don't want have to do a second procedure.Lifts have the disadvantage of requiring incisions. These incisions are something that has to be understood and excepted. Lifts do require incisions. They fade well most of the time but are permanent.Also, the decision to put in an implant in the opposite side could always be done later. So the lift or the implant on the good side can be done later. These are choices.If you put an implant in the good side, it will mean the left side gets a bigger implant. So your choice of breast size will be effected by this decision. For example, lets say you we're going to pick a 250 cc implant for the left side to give you symmetry. Now, if you want an implant on the right side to give a better shape, whatever size you pick on the right side, the left has to go bigger. So a 200 cc implant on the right now gives us a 450 cc implant on the left.I think you should weigh these new options before making a final decision. I have an office in Chadds Ford, not far from you.Check out my web page linked below. I would be glad to help.Dr Chris Saunders

Hello, thank you for your question. There are numerous ways a surgeon can approach symmetry issues, it mainly depends on his view of the problem. First of all, and I can only speak from my point of view, I don't like saline implants, I just don't think it provides the firmness and shape of the gel implant. Secondly, if you use an implant in one breast, the other one has to have an implant as well, even if it's small, because they won't look the same. A breast without an implant has a teardrop shape, where most of the volume resides in the inferior portion, while a breast with an implant will have upper pole fullness and a more beautiful cleavage. 

Depending on your expectations, if you want the best symmetry possible, a procedure will need to be done on each breast.  This will likely include an implant on the left and an implant and lift on the right.  If you don't place an implant on the right, you may not have as much fullness in the upper part of the breast.  If you don't do a lift, the nipples will be uneven in height to one another. Refer to case 2561 below

The difference between the breasts is more than just a matter of size. An implant in the left breast with no other intervention will not result in as good symmetry as can be accomplished.The best solution will depend on findings on examination and discussion of your goals. But at a minimum, a breast lift on the right side will be needed. I would suggest beginning some in person consultations to get a handle on the various options.All the best

Thank you for your very important question and photograph.  The difficulty with enlarging your small breast is that the nipple position and breast is much higher than the larger sagging breast on the opposite side.In my experience a reduction and lift of the larger breast is required if you are having the small breast enlarged.  If you simply have the small higher breast made larger in my opinion the asymmetry will be accentuated if the right breast is not reduced and lifted.  Please consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in breast asymmetry surgery and who has an excellent reputation in your community.