2 years post-boob job and uneven - is this asymmetry normal? Am I bottoming out? (Photos)

Question

It’s been almost two years since I got my breast augmentation, and I’ve noticed my right boob sits noticeably lower than the left. It’s not painful, but the asymmetry really bothers me - the right one looks droopier. I already had an ultrasound done and there’s no rupture. Am I bottoming out?

Semih Yildiz, MD, FEPOBRAS · Answer

At almost 2 years, a lower implant position is unlikely to be temporary swelling, but it is not possible to confirm bottoming out from a photo alone. I reviewed the photo; there is visible breast and implant asymmetry with one side sitting lower and a difference in the nipple-to-fold relationship, which can come from pocket stretch, implant position, natural breast tissue asymmetry, or mild tissue droop.
An ultrasound can rule out rupture, but it does not fully evaluate pocket support or the inframammary fold. An in-person exam should compare the crease position, implant mobility, skin stretch, capsule, and nipple position. If this is true bottoming out or pocket laxity, revision may involve tightening and reinforcing the lower pocket, sometimes with an internal bra material, and occasionally implant adjustment or a lift if the breast tissue itself is contributing.

Chet Mays, MD · Answer

Thank you for your inquiry!  We would love to meet with you to discuss you concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Daniel Barrett, MD · Answer

Dear Exciting61756,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

IMF asymmetry is very common. This can account for the differences you are noting. However, it is impossible to say without pre-op photos to evaluate.

A hallmark of bottoming out is a a rising IMF incision and star-gazing NAC.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Franklin D. Richards, MD · Answer

From the photo that you submitted, it looks like the right breast implant is in a very normal position. The left implant looks like it is sitting a little high. This could be due to several issues. Was the left nipple higher before your surgery? If so, then the left implant is actually in a good position, being placed directly behind the nipple. If not, then either you have a left capsular contracture or the left implant did not drop after your augmentation surgery. If the left implant is hard it is likely a capsular contracture. If it is soft then just lowering the plant should correct your issue. Neither breast is bottoming out.

Brian K. Reedy, MD · Answer

Thanks for sharing your photos! I would really like to see your before photos. Sometimes, we struggle to see asymmetry before and now we spend more time looking at our breasts afterwards. Maybe make a new post with your before photos!

Gary M. Horndeski, MD · Answer

Your breasts are wider than your chest wall and the weight of the breasts will cause breast descent. However, at this time, it does not look like you are bottoming out but are asymmetrical. You may want to consider placing a smaller implant in the larger breast and plicating the pocket slightly inferiorly.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

It appears that right inframammary fold is lower; that is the reason for this mild asymmetry. Without before surgery photos it is impossible to say whether it was result of surgery? Correction can be achieved with creation of new IMF, which will require replacement of implant in many cases. You should discuss risks and benefits with your surgeon. good luck.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photo. Subtle breast asymmetry is not the rule than the exception for most women. Breast augmentation often can magnify such differences. Your overall result appears to be excellent, but if you have concerns, discuss them with your plastic surgeon. Based on your photo I would not recommend revision surgery for this particular issue. Best of luck to you.

Camille Cash, MD · Answer

From the submitted photo it does not appear you are bottoming out.  The weight from the implants combined with other factors such as age, skin elasticity, or weight fluctuations can impact your results over time and it is completely normal that one breast looks a little different from the other.  The asymmetry can be addressed through surgical correction but you have to decide if it is worth it.  Visit with your surgeon to discuss your concerns and options.

2 years post-boob job and uneven - is this asymmetry normal? Am I bottoming out? (Photos)

Answers (10)

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