You are right: ALL breasts are asymmetrical and MAY be more apparently asymmetric by augmenting them with the same implants. With using the same volume range saline implants, one implant can be filled more than the other and this can correct mild size discrepancies. But if the different volumes of salt water are placed into each implants, they MAY have different stiffness. Another option is to use different size silicone implants OR to use the same silicone implants, sit you up during surgery and then use fat grafting to narrow the apparent differences.
A good way to asses the difference is to have a 3D VECTRA imaging which measures the actual breast volume AND can show you what you may look like with EVERY implant sold in the US BEFORE having surgery. WE offer it to our ladies and they love it because they can actually see what we are talking about based on our experience.
Peter Aldea, MD
Breast asymmetry may be improved with either varying size silicone or saline implants.
Keep in mind that following the
advice from a surgeon on this or any other website who proposes to tell you
exactly what to do without examining you, physically feeling the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of each operative procedure would not be in your best
interest. I would suggest that your plastic surgeon be certified by the
American Board of Plastic Surgery and ideally a member of the American Society
for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with.
You should discuss your concerns with that surgeon in person. If you are not comfortable with your initial consultation, I would suggest getting a second opinion.
Robert Singer, MD FACS
La Jolla, California
Thank you for your question regarding breast asymmetry. Although it is easier to make fine adjustments with saline implants, silicone implants are used all of the time for breast augmentation to correct breast asymmetry. Temporary sizers can be used in the operating room to determine the sizes required to achieve good symmetry prior to placement of the permanent silicone implants. I understand your desire to use silicone implants as they tend to feel and look more natural. Hope this helps.
One advantage of saline is that it has a fill range. This is usually 30 to 50cc's. If you don't want saline, another option is to use sizers to determine the best volume for each breast. Then place the appropriate sized silicone implants can be placed. Good luck!
It is true that with normal saline implants some fine adjustments in size can be achieved, that are sometimes harder to achieve with silicone implants, since they are pre filled. From an aesthetic standpoint you often cannot tell the difference between normal saline or silicone implants, but sometimes the saline implants feel less natural, especially in very lean patients. Since most breasts are to some degree asymmetrical, you should discuss your wishes, concerns, and expectations with your plastic surgeon when choosing your implants.
Best of luck
Bianca Knoll, Frankfurt Germany
Saline implants do feel firm and can ripple, especially in thin patients. If your breast asymmetry really bothers you, best to go with saline because the implants can be filled to different volumes to help obtain better symmetry. However, if the asymmetry is not a big deal to you (and yes, ALL breasts are asymmetrical!), then stick with silicone implants. Good luck!!
I would have to strongly disagree with the surgeon that told you to use saline implants because of asymmetry. Silicone implants will give you a more natural, softer and overall better look and feel to your breasts. Silicone implants come in a wide variety of profiles and sizes and allow for correction of most asymmetries.
Generally, the implants will come in approximately 25 cc increments in the smaller and medium sizes and will potentially jump to approximately 50 cc increments in the larger sizes. It is unlikely your asymmetry is going to be that noticeable after proper correction with implants. Although saline implants can make “micro-adjustments” with differential filling, this small advantage does not outweigh the higher risks of rippling and irregularities. A small degree of asymmetry as you noted is very normal and breasts that are too symmetrical can sometimes look less natural.
It is true that saline implants are easier to manipulate during surgery by simply adding more saline to one in order to create more symmetrical looking breasts. Would you feel comfortable posting photos? That might better help the question to see just “how” much different your right is from your left. Both silicone and saline implants are good choices, and I do not hesitate to use either in my patients. Silicone is more desirable in a thin body type with relatively little breast tissue or body fat. If you have decent breast tissue already, saline would also be a good choice. If you truly would prefer silicone to saline, discuss this with your surgeon. It is definitely possible to place two different sized silicone implants during your surgery. Often surgeons are able to place “sizers” in during the procedure and sit you up to best determine which implants would provide the most uniform appearance. I wish you luck in determining which implants are best for you!