Breast augmentation and correct breast/areola asymmetry at the same time?! Recommendations for wish pic? (photos)

5"6 126pounds, 34a. Have always been an A cup but after breastfeeding my boobs lost their perkiness, nipples droop and have areola assymetry. Also one breast flat compared to the other. I'm hoping all this can be addressed in one surgery. Advice?! Also what what be best profile hp or moderate plus for wish pic results?! I have been advised based on measurements that 450cc is the absolute max I could have - what would you recommend for desired look?! Love shape & size of wish pic.

Doctor Answers 10

Yes, should be possible to address both issues, but might come with a price...

Hello, thanks for the question.

Yes, it should be possible to improve the areola asymmetry, but it depends on what you mean - if it is the difference in the diameter (your left looks a bit larger in the photos), then this can be reduced, but you will pay a price - you have a scar going all the way round the areola, this might be something you won't like. It might be worth just leaving this be as the difference in areola diameter might be less noticeable on larger breasts.

It also looks like your breasts are a slightly different size, with the left appearing larger in the photos - this is difficult to tell here, because it might be that your ribs stick out further on the left, pushing that breast forward and making it appear bigger (not that uncommon by the way!) - so this will need assessing in person.

You might therefore be a candidate to have different sized implants put in on each side, to balance up the size asymmetry.

The only thing that worries me a little from what you say is the implant size you have been recommended. Even 450cc seems very large going by your frame in the photos. I think implants this size could very well make you have very round, fake-looking breasts ie nothing like you have indicated in the desired photos. Please think carefully about this.

Yes, should be possible to address both issues, but might come with a price...

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Hello, thanks for the question.

Yes, it should be possible to improve the areola asymmetry, but it depends on what you mean - if it is the difference in the diameter (your left looks a bit larger in the photos), then this can be reduced, but you will pay a price - you have a scar going all the way round the areola, this might be something you won't like. It might be worth just leaving this be as the difference in areola diameter might be less noticeable on larger breasts.

It also looks like your breasts are a slightly different size, with the left appearing larger in the photos - this is difficult to tell here, because it might be that your ribs stick out further on the left, pushing that breast forward and making it appear bigger (not that uncommon by the way!) - so this will need assessing in person.

You might therefore be a candidate to have different sized implants put in on each side, to balance up the size asymmetry.

The only thing that worries me a little from what you say is the implant size you have been recommended. Even 450cc seems very large going by your frame in the photos. I think implants this size could very well make you have very round, fake-looking breasts ie nothing like you have indicated in the desired photos. Please think carefully about this.

Breast augmentation and correct breast/ areola asymmetry at the same time?! recommendations for wish pic?

Hi there, 

Thank you for your question. Yes, all of your concerns should be able to be addressed in one surgery. It is difficult to provide accurate information without an in person assessment and discussion regarding expectations. 

Best, 

realdrsix

Breast augmentation and correct breast/ areola asymmetry at the same time?! recommendations for wish pic?

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Hi there, 

Thank you for your question. Yes, all of your concerns should be able to be addressed in one surgery. It is difficult to provide accurate information without an in person assessment and discussion regarding expectations. 

Best, 

realdrsix

Breast augment with areolar asymmetry

measurements are always a good idea but the use of sizing implants during the procedure to see how they look and feel before you open the implants you end up choosing.  It is always  best to have multiple sizes available to choose from.  The sizers also enable the surgeon to modify the implant spaces ( selectively open or close off space with internal sutures ) before placing the final implants. silicone gel filled implants may be a good choice because there is not a lot of tissue to cover saline filled implants. incidently the saline one time use sizers may used as  expanders to stretch the tissues ( if needed ) by overfilling them.  It may be wise to defer the areolar asymmetry until a later time as the stretching of the tissues could undo the areolar repair or cause excess scar widening around the areolar repair.

Breast augment with areolar asymmetry

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measurements are always a good idea but the use of sizing implants during the procedure to see how they look and feel before you open the implants you end up choosing.  It is always  best to have multiple sizes available to choose from.  The sizers also enable the surgeon to modify the implant spaces ( selectively open or close off space with internal sutures ) before placing the final implants. silicone gel filled implants may be a good choice because there is not a lot of tissue to cover saline filled implants. incidently the saline one time use sizers may used as  expanders to stretch the tissues ( if needed ) by overfilling them.  It may be wise to defer the areolar asymmetry until a later time as the stretching of the tissues could undo the areolar repair or cause excess scar widening around the areolar repair.

Breast Implant Size Options

Hello,


Thank you for your question and photos. With a significant volume of implant placed you may find that your small volume difference is washed out. Two different sized implants can be used when necessary for large asymmetries. Dimensional breast augmentation factors your existing tissue and breast measurements to select a few implant options which fit you proportionately. My patients find it helpful to try on the implants in the office with a form-fitting T-shirt in order to get an idea of how they will look. Be sure to select a board certified Plastic Surgeon who specialises in the area of your procedure.


All the best

Breast Implant Size Options

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Hello,


Thank you for your question and photos. With a significant volume of implant placed you may find that your small volume difference is washed out. Two different sized implants can be used when necessary for large asymmetries. Dimensional breast augmentation factors your existing tissue and breast measurements to select a few implant options which fit you proportionately. My patients find it helpful to try on the implants in the office with a form-fitting T-shirt in order to get an idea of how they will look. Be sure to select a board certified Plastic Surgeon who specialises in the area of your procedure.


All the best

Breast augmentation

You will able to improve the size and shape.  Your physical exam and breast characteristics will dictate the implant choices available.  3d imaging can be used to help you better understand what you may look like after afterwards.

Breast augmentation

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You will able to improve the size and shape.  Your physical exam and breast characteristics will dictate the implant choices available.  3d imaging can be used to help you better understand what you may look like after afterwards.

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Breast Augmentation - Size Selection

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

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

You can have your wish pic result!

Happy 86:  You have a good natural shape for breast augmentation and I think all of your desires are possible with one surgery, although I don't think I would attempt to make the areolar diameter more equal.  They are pretty close now and to address this slight asymmetry would require an incision completely around the larger one, which in my mind would be worse than the slight asymmetry you now have.

I agree that I wouldn't probably recommend more than 450 cc for you.  Regarding the profile, that is a choice I usually ask the patient to leave to me during surgery.  If I find your tissues to be tight once the dissection is complete I generally will place a higher profile implant.  If your tissues are more lax, I generally will place a moderate profile.  At any rate, I think an excellent result for you is quite possible.

Best of luck to you!

G. Robert Meger MD

You can have your wish pic result!

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

Happy 86:  You have a good natural shape for breast augmentation and I think all of your desires are possible with one surgery, although I don't think I would attempt to make the areolar diameter more equal.  They are pretty close now and to address this slight asymmetry would require an incision completely around the larger one, which in my mind would be worse than the slight asymmetry you now have.

I agree that I wouldn't probably recommend more than 450 cc for you.  Regarding the profile, that is a choice I usually ask the patient to leave to me during surgery.  If I find your tissues to be tight once the dissection is complete I generally will place a higher profile implant.  If your tissues are more lax, I generally will place a moderate profile.  At any rate, I think an excellent result for you is quite possible.

Best of luck to you!

G. Robert Meger MD

Breast augmentation and symmetry correction at the same time?

All your concerns can be addressed in one surgery. Breast asymmetry can be addressed with different size implants, and the larger areola can be surgically reduced. An in-person consultation, as you had with your plastic surgeon, is necessary to determine the right size for your goal. A surgeon needs to measure you and then review pictures of women similar to you to assist you in achieving your goal and meeting your expectations. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

Breast augmentation and symmetry correction at the same time?

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

All your concerns can be addressed in one surgery. Breast asymmetry can be addressed with different size implants, and the larger areola can be surgically reduced. An in-person consultation, as you had with your plastic surgeon, is necessary to determine the right size for your goal. A surgeon needs to measure you and then review pictures of women similar to you to assist you in achieving your goal and meeting your expectations. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

Breast augmentation and correct breast/areola asymmetry at the same time?

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery (and possibly unilateral areola reduction). Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.


Having said that, I find that most patients looking for the outcome that you demonstrate in the goal photographs benefit from the use of "higher" profile breast implants.  I find that I am using moderate or moderate plus profile breast implants less and less in my practice.


  Generally speaking, the best the online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:


1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.


2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “C or D cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.


3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Breast augmentation and correct breast/areola asymmetry at the same time?

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

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery (and possibly unilateral areola reduction). Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.


Having said that, I find that most patients looking for the outcome that you demonstrate in the goal photographs benefit from the use of "higher" profile breast implants.  I find that I am using moderate or moderate plus profile breast implants less and less in my practice.


  Generally speaking, the best the online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:


1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.


2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “C or D cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.


3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

BBA and nipple asymmetry

Thanks for your question. There doesn't seem to be any major asymmetry better your nipples/areolae, so I am not quite sure which aspect of them you are concerned about? Your nipples do sit quite lateral on your chest wall. I would therefore probably choose a lower profile, but wider implant, for you so that nipples do not end up pointing outwards after a breast augmentation, or leave you with a wide cleavage due to positioning the centre of the implant directly under your nipple/areolae. However nothing beats a face to face discussion and assessment, and you should try on some sizers to get an ideal of size and shape.

BBA and nipple asymmetry

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Thanks for your question. There doesn't seem to be any major asymmetry better your nipples/areolae, so I am not quite sure which aspect of them you are concerned about? Your nipples do sit quite lateral on your chest wall. I would therefore probably choose a lower profile, but wider implant, for you so that nipples do not end up pointing outwards after a breast augmentation, or leave you with a wide cleavage due to positioning the centre of the implant directly under your nipple/areolae. However nothing beats a face to face discussion and assessment, and you should try on some sizers to get an ideal of size and shape.

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.