Every patient's anatomy is different. There are various alternatives that are may produce the best result in the appropriate patient depending on her individual anatomy: Different size implants may significantly improve your asymmetry. But you need to be realistic that a patient starting with your degree of difference in breast size and shape will rarely if ever have perfectly identical breasts post-operatively. There are currently a wider variety of types and shapes of silicone implants than existed previously. They vary in: outer surface texture, dimensions of width and height, projection, silicone gel densities, as well as volume. The fact that there are more options is confusing to most patients, but beneficial in helping to achieve an optimal cosmetic result for each patient's particular anatomy. .Following the advice of anyone on this or any other website who would presume to tell you exactly what to do based on 2 dimensional photos without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person, and try on sizers.Robert Singer, MD FACSLa Jolla, California