Lopsided 9 wks post op. Left has dropped but right is very high and looks smaller. Do I need time or more surgery? (Photo)

335ccs. Left implant seemed bigger & the right implant felt like it was going into my armpit. Left one has dropped and settled, the right is still high & looks a size smaller. I'm lopsided, even in a bathingsuit. Massaging since 4 wks -dr orders. I'm right handed & play guitar. Should I stop all activity? Need further surgery? If it does settle, I'm concerned it will still be severely smaller than the left. I have attached 5 photos for thorough evaluation. Thank you all so much in advance.

Doctor Answers 8

Lopsided 9 wks post op. Left has dropped but right is very high and looks smaller. Do I need time or more surgery?

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Congratulations on your surgery! I know you may be frustrated at this point but try not to worry.  Pre-op photos would be helpful for comparison & to see if your right breast was smaller to start off with.  An in-office exam would be recommended to make sure that you are not developing a capsular contracture on your right breast which could explain why it's higher and appears smaller than your left breast.  If that is the case, your surgeon will let you know your options from oral medications to aggressive massaging to surgery.  Sometimes one breast can just lag behind the other in the healing process too so it really would be a good idea to see your surgeon as soon as you can to rule out capsular contraction and put your mind at ease.  ac

Newport Beach Plastic Surgeon

Lopsided 9 wks post op. Left has dropped but right is very high and looks smaller. Do I need time or more surgery?

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Yes the right inferior pocket either was not dissected or has not allowed the implant to drop and there seems to be a size difference in volume.. No befores were posted.. 

Asymmetry after breast augmentation

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Thank you for your pictures. I agree you look smaller on the right. The in equity in size maybe do suggest different sized implants or you may have on for seen Chestwall abnormality. I have seen this from time to time when it's not recognize by examination but recognized once the implants are placed.  There is a small depression on the side it looks smaller and the implant settles into that chest wall deformity. I would definitely seek revision of your right breast. This is the one time in my opinion that a Vectra analysis of your breast chest wall would be helpful.

Good luck.

Earl Stephenson Jr MD DDS FACS

Lopsided at 9 weeks, Time or Surgery

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The difference between the two sides is readily apparent. Pre operative assessment provides size, comparison of that size, position of the breasts on  the chest wall and position of the infamammary fold.. An evaluation now, without the benefit of this pre op assessment,  renders an assessment based on the submitted photos only, problematic. Recommended is continued massage and reassessment at 6 mos. Please follow up with your operating surgeon.


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After 9 weeks breast implants should have already fallen.  Your right breast implant is significantly higher than your left.  It is imperative that you re-consult your plastic surgeon for them to determine what is holding the right breast implant up- tight muscle, capsule.  Chances are a revisionary surgery may be required.
All the best!
Dr. Tony Perkins.
Plastic Surgery of Short Hills

Anthony Perkins, MD
Short Hills Physician

Asymmetry after breast augmentation

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I do see the asymmetry.  Many things can cause this.  If the right breast was smaller and higher before surgery that could be an explanation.

You need to be examined by your plastic surgeon to make sure your not forming a capsule on the right breast.  A capsular contraction and push the breast implant higher and make it look smaller.

By 9 weeks the right implant should have distended.  Problems like this can usually be revised.  Please speak your plastic surgeon.

Massage vs Surgery

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What did you start with?  Did you have a right breast that was slightly higher and smaller?  Did the right side seem to get smaller compared to the left after surgery?  Did the right side seem to move up compared to the left, or has it always been the same and the left just moved down?
These are some of the questions that would be useful before being able to answer your question correctly.
In general, if one breast sits higher, you can concentrate your massage on that side to help it catch up with the other breast that has settled in.  If there is no response after a about 3 months, then it may be time to consider a surgical release.  If you are under the muscle, the muscle attachments along the bottom of the breast may need to be released.  As to the size asymmetry, there are many possible answers to that depending what would be found in you history and physical.  Speak to your PS who is best suited to figure out what is going on and what can be done.

Right breast implant much higher than the left.

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I see this condition often after breast augmentation with smooth implants.  If you were moving around after surgery and not resting you may develop some bloody collection on the more active side.  This is usually on the bottom of the right breast if you are right handed.  If you are right handed you will generally use the right arm 3X more than the left.  If this happens early after surgery blood will collect on the lower pole of the right breast.  Where blood collects is where scars may form.  This causes the lower pole to develop more scar tissue which contracts and pushes the implant upwards.  Occasionally there is blood throughout the implant which will cause the breast pocket to contract in all directions.  This causes the affected breast to become visibly smaller compare to the non scarred breast.   Usually a lot of massage and Singulair might help a little but rarely does the right breast become symmetrical with the left.  Most likely you will need another surgery to remove the scar or capsule from the right breast. 

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.