Will my breasts even out with time or do I need a revision? Please help (Photo)

I am 3 months post op transax submuscular moderate silicone, preop 34 b. My left breast was the smallest so my surgeon placed a 485cc on left and 405cc on right. Now my left breast is way bigger than right. I would like to know what my options would be. Does this require a revision or will the sizes even out with time? Thank you.

Doctor Answers 7

Breast Asymmetry after Augmentation

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You do have some significant asymmetry at this time.  3 months is still relatively early in the healing process and I would recommend waiting another 3 months to see if things will even out.  An 80cc difference in implant size is fairly large.  Did your surgeon use sizers to choose your implant size?  Were photos taken in the OR at the time of placement?  If intra-operative photos show good symmetry then your breasts should end up being symmetrical in the long run.  

I would recommend close follow-up with your plastic surgeon.

Honolulu Plastic Surgeon
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Breast Augmentation - Post Op Swelling

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Thank you for your question. You are still very early in the post-operative period. It typically takes 3 - 6 months for the swelling to subside and and implants to settle into proper position. The implants may swell asymmetrically, as in your case, but usually settle evenly. Please discuss your concerns with your board certified plastic surgeon. Also, make sure you follow all of your plastic surgeons post-operative instructions regarding level of physical activity and use of a support bra. Hope this helps and good luck with your recovery.


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Thank you for your question and photo. Asymmetric swelling is not uncommon- especially when a larger implant is placed in a smaller breast- swelling can last slightly longer on that side. I recommend that you allow a few more months for settling before evaluating your results.

All the best

Asymmetry following transaxillary breast augmentation

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I agree with you that you have some noticeable asymmetry in size.  You are still only 3 months following surgery so you are still healing and there may still be some swelling and scar tissue that needs to subside.  Most surgeons (including myself) will have their patients wait at least 6- 12 months to give them enough time to heal and settle.  It appears that you may have had some asymmetry to begin with (given the different size implants chosen for you) and since silicone gel implants come in limited sizes, it's difficult to make them perfectly symmetric in size post- operatively. Having said that though and if your degree of asymmetry does not improve, there are a few size options between your 405- 485cc's that may be used to help you achieve better symmetry.  Those sizes are fairly large to try to force through an axillary incision, and in my opinion would be more difficult and risky as far as implant malposition (due to inadequate muscle release and control of the inframammary fold) and tissue trauma (because you can't see as well with increasing risks for bleeding and resulting capsular contracture) and implant trauma (some implant manufacturers warn against placing their silicone gel implants transaxillary for this reason).  But I am sure you will find some plastic surgeons who will disagree.  There is usually more universal consensus, however, that revision surgery is more complicated to do especially through the axilla so most transaxillary breast aug patients now have to deal with a second incision (and statistics will tell you that you are almost guaranteed to have another surgery (or even more) within your lifetime so the reward of a transaxillary incision to avoid a incision on the breast that most patients don't mind (and much easier to revise if the scar does not heal properly than a major revision for implant asymmetry/ malposition/ capsular contracture/ rupture) is usually short lived.  There are studies reported in well respected journals in our specialty that show a much higher rate for complications (including malposition- surprise, surprise) and revision rates for the transaxillary approach.  There is a good reason why most plastic surgeons don't offer this approach.  Best wishes.

Will my breasts even out with time or do I need a revision?

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 I am sorry to hear about your concerns after breast augmentation surgery. Your plastic surgeon will always be your best resource when it comes to an accurate assessment of your situation, advice, predictions, and/or meaningful reassurance.
Generally speaking, breast implants will "drop" into the pocket that was created during surgery and massaging the implants downward may assist in the dropping of the implants after surgery (for those patients who want to help with the settling of the implants). The rate of breast implant "settling" may depend on factors such as size of breast implant pocket dissected, tightness of the overlying skin/muscle layers, and size of breast implant utilized.
Normally, it takes about 3-6 months (for some patients longer) to see the final result. It is very common for one side to settle faster than the other.
Sometimes, one or both breasts implants do not settle as planned and revisionary breast surgery becomes necessary to improve the outcome. On other occasions, if the long-term breast asymmetry is mild (understanding that absolute symmetry is very rarely achieved), patients will need to decide whether proceeding with revisionary breast surgery is worth the potential downsides associated with additional surgery.
Again, best to follow your plastic surgeon for more specifics. Best wishes for an outcome that you will be pleased with long-term.

Will my breasts even out with time or do I need a revision? Please help

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I do see the asymmetry that you have.  I would wait another 3 months for all of the swelling to resolve on the left and hopefully for the right side to drop further..  If the asymmetry persists at 6 months that you will likely need a revision.  Keep in touch with your plastic surgeon.

Will my breasts even out with time or do I need a revision?

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Thank you for your question.

There is a noticeable difference in the size of your breasts.  There can still be some swelling and healing that has to take place.  I would recommend waiting another 2-3 months to see all of the healing resolved.  If at that time you still have asymmetry then a revision would be needed.   

I would discuss this with your plastic surgeon, if you haven't already, so that you are both on the same page as to the next steps.

Good luck.

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.