Breast asymmetry after augmentation - can this realistically be fixed? (Photo)

Question

I had 1 tuberous breast. I got 285cc round silicone Subfacial to each breast. Donut lift was peformed to the L breast. I am not happy with result. The lower breast crease still seems too high on the L side, plus it is not symetrical to the mid line. The left implant is also sitting higher and giving a bad side profile shape. The donut lift has made my nipple larger. Can this realistically be fixed? What i required? I also have rippling at my cleavage

Daniel Barrett, MD · Answer

Dear xxana,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Tyler Frew, MD · Answer

Hi there,
Yes, these things can be corrected. You will need a detailed exam and you surgical records with you so the MD can read exactly what was done.
You would benefit from internal capsule work to repair the large right pocket and adjust the IMF's so they are equal. Also consider a change of plane to place the implant below the muscle to improve the side shape and get rid of the rippling.
All the best

Connie Hiers, MD, FACS · Answer

The left implant can be lowered some and the areola can be tightened to be made smaller. You still won't have equal breasts, but should be improved.

Mats Hagstrom, MD (license on probation) · Answer

Generally speaking, there are three variables that determine breast augmentation outcomes.
The first is patient candidacy.The second is the choice of implants in regards to size shape, and type.
The third is the surgeons ability to place the implants in the correct anatomic location.
In your case, your candidacy was less than ideal.
Your nipples are highly divergent and you have pressed a symmetry.
Most people have a left breast that sits higher on the chest wall than the right side.
This was true for you preoperatively as well.
Even though your left breast had greater ptosis the left infra mammary fold was higher than the right side before surgery.
Surgeons should not move the infra mammary fold.
If you look at anatomy pictures for the pectoralis muscle, you will see that the central pectoralis muscle is not covered in fascia.
The tenderness, insertions and origin of the muscle has short segments of fascia, but the main muscle does not get
There is no sub facial plain on the pectoralis muscle.
You’re right breast has started to bottom out slightly.
This is most likely related to the technical placement of the implant, which is in part related to the decision to place the implant above the pectoralis muscle.
Placing the implants more immediately to create a look of cleavage, increases the appearance of nipple divergence.
Generally, speaking augmentation is going to make nipple divergence more obvious because it causes breast projection. This is something patients need to take in the consideration when having breast augmentation.
Patients who have highly divergent nipples are going to worsen the appearance of the divergence.
In the end, your candidacy for quality breast augmentation was inherently limited.
The surgical outcome is fairly decent. With the exception of the right implant beginning to bottom out.
Using large implants tends to increase the chance of undesirable side effects, and in your case will worsen the divergence.
And a nutshell, all three variables are involved in your outcome to some degree, but the biggest variable was your candidacy for the procedure in the first place.
I hate to be so forward and wish I could be a little more optimistic.
I say it like it is.
 I’m not sure if revision surgery is indicated at this point.
I suggest you wait a bit to see if you’re right implant begins the bottom out more.
If it does, you probably need to have that corrected.
Best,
Mats Hagstrom, MD

Breast asymmetry after augmentation - can this realistically be fixed? (Photo)

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