Hello Beth, It is always complicated dealing with asymmetry and the results are often a compromise. The problem with an uplift is that it does give more scarring and there is more potential complications, but it does improve the shape. The symmetry could be improved with implants of different dimensions, but I suspect you will always have a degree of asymmetry even after surgery.If you are not comfortable with the advice you have been given, then I recommend that you seek other opinions as it is often helpful to get another viewpoint. The BAAPS and BAPRAS websites have lists of plastic surgeons in your area and you can look for one who specialises in breasts. You are welcome to come along to my webinar where I discuss the issues in choosing breast implants (see link below). Good luck.
Asymmetry is one of the more difficult problems to fix with breast augmentation . We all have natural asymmetry in our bodies. After augmentation with or without lift there will still be some slight asymmetry. That is the natural condition of the human body however your breasts should be able to be much more symmetric . From your photo it is difficult to determine whether you absolutely need a lift. In situations like this I use a temporary sizer during surgery as well as temporary percutaneous sutures to approximate the appearance of a lift. The patient is then set up during surgery as adjustments are made. This allows customized control over the final appearance and the closest result to your wish result The most important factor for you is to pick the most experienced breast surgeon as cases like yours are not a simple fix
Thank you for the question and pictures. Ultimately, you will do well spending additional time with your plastic surgeon communicating your goals, questions, and concerns. In other words, careful measurements, dimensional planning, and careful communication will be key.
Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. Breast lifting involves some removal of breast skin envelope; there may be limits as to how large of a breast implant can be utilized safely. For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural” or "D or DD cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
I hope this, and the attached link, helps. Best wishes.