Asymmetrical breast.Not looking for perfection but something close to having both breast look alike.Will I need revision?(photo)

What are your opinions? I'm 4 months post op

Doctor Answers 8

Breast Asymmetry

You will need to be examined to determine what needs to be done to improve symmetry. This may include changing implant size, but it definitely will include fixing the dropout of that one implant. This is, of course, going to require a revision surgery.

If your doctor isn't an ABPS certified/ASAPS member surgeon that specializes in revision breast surgery, you should go on some consultations with surgeons that are. This is not an easy surgery to perform, and should be done so by someone that has consistently good results.

Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Twins vs. Sisters

Thanks for your pictures and questions.  Congratulations on making it through your surgery.  Your pre-op breasts were not symmetrical (which is quite common) so it is often very hard to make them exactly symmetrical post-op.  I often talk with my patients about the fact that we might not have "twins" after surgery that "sisters" is a great look.  We want to of course avoid "cousins or close friends."  However, any concerns, contact your surgeon for an appointment and see what their recommendation is. 

All the best,
Steven Camp MD

Steven M. Camp, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 93 reviews

Uneven Breast Incisions after Augmentation

It is quite common for the two breasts to heal differently. One may swell more, one may feel more uncomfortable, or the shapes may differ initially. After complete healing, they should look more similar and natural. Patience is required, but if you are concerned, ask questions to your doctor or the nursing staff.

#breastrevision #breastimplants

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Breasts uneven

Your breasts were uneven to begin with; you should consider a left breast inframammary crease adjustment sueperiorly and right breast implant replacement enlargement.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Asymmetrical breast.Not looking for perfection but something close to having both breast look alike.Will I need revision?

Your resolve looks very good considering the significant asymmetry that you had preop.  If you insist on attempting to achieve better symmetry I would recommend placing a smaller implant on the left larger side and closing the pocket at the bottom and doing an aerial reduction and nipple left on the right side in an attempt to match the left side.

For more on breast asymmetry please read the Link below:

Bottomed out implant

The left breast postoperatively seems to be lower in the pocket causing the appearance of the nipple to be high.  When a breast implant migrates below the original placement location with the bottom of the implant just above the infra-mammary crease, we call this “bottoming out.” There are several causes of this downward migration of the breast implant. Usually, some attempt had been made to lower the crease to accommodate a breast implant whose base diameter is larger than would otherwise fit in the natural breast. In doing so, the anatomic attachment of the skin of the breast to the chest wall can be obliterated. There is then nothing to hold the implant up. With the weight of the implant, and constant gravity, maybe lack of support by lack of wearing a bra continuously, the implant can settle downward. One of the earliest symptoms, I see in patients seeking revision,has been the feeling that the breast has to be constantly adjusted or just feels heavy. We look for the incision line, which was previously placed at the crease, to have migrated upward onto the breast. When we see this early on in the postoperative phase, it will never get better with time and will require a secondary repair. While some plastic surgeons may rely on suturing techniques only, I have found that unless we un-weight the implant by making it smaller or strengthen the tissues below by making them less stretchy, that the same implant, with  just sutures placed on the bottom of the pocket, will, over time, recur it's bottomed out position. I have used part of the capsule as well as the lining of the deep muscles and tissues over the ribs in the capsule beneath the breast implants to rotate upward to hold the breast implant in a higher position and therefore obliterating the extra space that has been created between the correct infra-mammary crease and the one created by the downward displacement of the implant. I call this a three flap technique, as the skin, the capsule and fascia (lining of muscles), as well as a dermal flap all contribute to creating a hammock like support of the lower portion of the pocket. When these tissues are insufficient to hold the implant up, or a previous attempt has been made with sutures, I will oftentimes rely on the addition of another type of tissue called an acellular dermal matrix of which my preference is Strattice. This Strattice ,or pigskin, does not stretch and can be sewn in to the bottom of the new location of the crease to support it just like a hammock would. Although this is costly, I consider this an insurance policy against having to redo this again. I would recommend that you try and find a plastic surgeon with experience in revisionary cosmetic breast surgery. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Asymmetrical breast. Will I need revision?

I am sorry to hear about your concerns after breast augmentation surgery. It is helpful that you have posted your before pictures also; you demonstrate nicely that breast augmentation often serves only to increase breast size.  In other words, the breast implants have settled into the pre-existing asymmetrical breast skin envelope,  leading to ongoing breast asymmetry.

Best to discuss your concerns/goals directly with your plastic surgeon who will be in your best resource to advise you. Revisionary breast surgery will certainly help improve your outcome it comes to breast asymmetry. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Asymmetrical breasts. Will I need revision?

Thank you for the question and photos. You demonstrate asymmetry preop and this is the same postop, except you have larger breasts. You do not state if you have same size or different size implants. At this point, if your left fold is raised, your nipple levels will be more symmetrical. BTW, you have a very nice result, from your preop starting point. Discuss this with your plastic surgeon. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

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.