One of the doctors I have seen told me I should choose saline because my breast is asymmetrical. Is this true?

He said because my right side is bigger and a little bit more saggy, I would need saline to play with the sizes of each one. But my understanding was that all breast are asymmetrical. I don't like the idea of saline because I have heard they look less natural and feel harder. Is this true?

Doctor Answers 8

Correcting Breast Asymmetry with Breast Implants

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.

Good Luck
Peter Aldea, MD

Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

One of the doctors I have seen told me I should choose saline because my breast is asymmetrical. Is this true?

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

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

One of the doctors I have seen told me I should choose saline because my breast is asymmetrical. Is this true?

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.

Nicholas Tarola, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 62 reviews

One of the doctors I have seen told me I should choose saline because my breast is asymmetrical. Is this true?

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!

Keith Hodge, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 30 reviews

Saline breast implants vs silicone implants in asymmetric breasts

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

Bianca Knoll, MD
Frankfurt Plastic Surgeon
5.0 out of 5 stars 41 reviews

One of the doctors I have seen told me I should choose saline because my breast is asymmetrical. Is this true?

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!!

Farah Naz Khan, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 100 reviews

Asymmetry and Saline Implants

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.

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 54 reviews

Saline implants for asymmetrical breasts

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!

P. Craig Hobar, MD
Dallas Plastic Surgeon
4.8 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.