350cc & 450cc, pectoralis muscles too tight, could we revise the size of smaller implants? (Photos)

Question

My PS said there was some asymmetry so he went with a 350cc and 450cc. I am noticing a big difference now 6 mpo out the smaller one is noticeable smaller. I feel he should have went with something closer to the 450 since there wasn’t a huge difference in before. Ps said my pectoralis muscles were really tight making it difficult to get my implants behind the muscles. Will they ever drop and allow my breast to get to the size allowed for a 450cc? Could we revise the size of the smaller implants?

Ronald J. Edelson, MD · Answer

Using different size implants for  asymmetry is a very tough game to get right.  But I agree the size difference is too great and changing the size of one of the implants does  make sense.  If you were my patient I would let you make the decision regarding size change.

Karl William Schwarz, MD · Answer

When I started out as a plastic surgeon and I had a patient with asymmetry I used to always place different sized implants like you had done. What I found over time is exactly what you have experienced. Over time, 6 months to 24 months what happens is the larger implant becomes noticeably larger. I say the implant always wins in the end, meaning that eventually it is the implant that becomes the dominant component of the breast and then implants that were placed to correct asymmetry actually generate MORE asymmetry.

Today I still use different sized implants in patients with notable asymmetry, but I keep the implant sizes much closer together in size, say 25 cc or 50 cc and not go for the 100 cc difference as I know with time we will have reversed the problem in that the originally smaller breast will now look markedly larger if I use markedly different implants. In other words, the patient will now see the asymmetry in the implants which is usually more pronounced than the original asymmetry.

For patients that have a normal amount of asymmetry, not something that really stands out, but a little asymmetry (super common), then I use the same sized implants in each breast and I explain to the patient before surgery that there will be a little asymmetry as she has now but that it is better than if I put different sized implants and she will see the different implant sizes in a year. Most people understand this and are happy to accept a little normal asymmetry rather than be left with one large breast and a smaller one.

Richard Baxter, MD · Answer

if the muscle is too tight for placement of the implants then it might be a good option to place them over the muscle. I prefer subfascial for this. If you had dual plane under muscle, then the muscle should be re-attached where it was cut. Fine-tuning the implant size for better symmetry might be easier with over muscle/subfascial, but there may be other things to consider.

Christopher J. Morea, MD · Answer

Based on your pictures it does appear you have a size asymmetry. This is something that can easily be resolved. I have been in practice for over25 years and augmented thousands of breasts. I have not encountered a pec muscle to tight. I have seen many pts who have had implants way to large for their dimensions for revisional surgery. I would talk with your PS as after 6 months the pec muscle will have expanded. I hope this helps.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, I believe your surgeon should be able to revise you to create symmetry.  I am unsure how to comment about your tight pectoralis muscle, but usually there is significant stretch and relaxation over the first six months, best of luck.

Daniel Barrett, MD · Answer

Dear Glorious119530,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

350cc & 450cc, pectoralis muscles too tight, could we revise the size of smaller implants? (Photos)

Answers (9)

Answer: Revision

Answer: Revision

Answer: Breast revision

Answer: Breast revision

Answer: BA results

Answer: BA results

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

350cc & 450cc, pectoralis muscles too tight, could we revise the size of smaller implants? (Photos)

Answers (9)

Answer: Revision

Answer: Revision

Answer: Breast revision

Answer: Breast revision

Answer: BA results

Answer: BA results

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.