Thanks for your photos. My first question would be to identify which side you like better. With the limited information provided, I might suggest downsizing the left implant with capsulorrhaphy of the inframammary pocket to re-establish a higher inframammary fold position. The areolar site asymmetry should improve with the lower projection and volume. Alternatively, the right breast could be upsized with a larger implant and the inframammary crease lowered. It would be helpful to know what natural asymmetry was present on your preop photos, but your next revision will likely require an inframammary incision on one side.
Breast asymmetry after augmentation
It would be helpful to have preoperative photos to assess whether you had some asymmetry in both size and nipple position before surgery - most women do. Looking at the photograph you have provided, you certainly have asymmetry now in both size and nipple position. At five months after surgery, you are unlikely to experience further significant change - therefore I think what you have is what your end result is.
To restore symmetry, at a minimum you would need to decrease the size of your left breast. Part of the asymmetry likely comes from the fact that a 485 cc implant probably has a wider diameter than the 405 cc implant. This explains why the upper contour of the implant sits higher and more prominently on the left side.
Your nipples are also asymmetrical, with the left sitting higher than the right. It is always easier to raise a nipple than to lower one, because lowering a nipple involves leaving a scar on the breast above the nipple, which is unsightly and sometimes visible in clothing. It is possible that simply adjusting the size of the implant on the left may help to resolve this asymmetry, but more likely you will need a mastopexy (lift) to the right side to achieve better symmetry. A capsulorrhaphy will tighten the pocket that an implant sits in, but I don't think this will correct the entire asymmetry. Talk to your original surgeon about your concerns that capsulorrhaphy may not address the problem and hopefully that will generate a good discussion about all of the potential options. Good luck!
It is difficult to say without seeing you in person but it might also take a smaller implant to be placed on the left side, as well as a capsulotomy, not a capsulorraphy.
Without an exam it is difficult to provide specific recommendations. The nipples are uneven and the volume of the breast don't match. From the photos It looks like you need a reduction in volume on the left or an increase on the right and areolar mastopexy on the right. I would discuss your concerns with your surgeon.
Wait for some time
The final shape of your breasts will start to look its best approximately three (3) months after surgery. It takes time for the skin and muscle to stretch and relax around the new implant. The breast will often look higher, firmer, and "less natural" in the first three (3) months. It can take up to a year to see your final result.
How to correct uneven breasts after breast augmentation.
Thanks for your question in the breast augmentation forum. There are really only two methods to correct asymmetries after breast augmentation without performing a "lift" or adding additional scars:
- change the position
- change the size
It is difficult to determine from photographs alone, but it appears like your implants are reasonably close in position (perfect symmetry of implants is rarely possible), but the breast on the right side of the photograph appears much larger. This could be because of the size of the implant selected or because of seroma (fluid collection around that implant). Your nipple position is also unequal, but that is most likely because your nipple position wasn't symmetric prior to surgery as well. The only way to change nipple position is with adding scars around the areolas etc and I don't know if that is worthwhile for you.