What could cause my right breast to look smaller and have less projection? Both were even prior to surgery. (photo)

I had surgery four weeks ago and received 421 cc silicone moderate profile. My right breast looks smaller and more center than my left breast. My breasts were pretty even before surgery so I am confused. Could it be the implants are placed differently on each side? When I wear an unlined bra and in certain shirts I can tell the right breast is slightly smaller.

Doctor Answers 9

Your breasts need more time to heal.

You’re at 4 weeks after your breast augmentation procedure but your final results are still months away. It can take up to 6 months for your breast implants to drop into the breast pocket. During those months of healing and adjustment, your breast may look different. It’s easy to think of your breast augmentation as a single procedure but you actually had two surgeries—one on each breast—so your breasts may heal and settle at different speeds. Give your body time to heal and allow your skin and tissue to stretch and accommodate your breast implants. If you’re still concerned about your results after 6 months, you may want to schedule an appointment with your plastic surgeon. 


Dallas Plastic Surgeon
5.0 out of 5 stars 109 reviews

Submuscular implants

You did not mention if your implants are above or below the muscle.  I have seen a sub set of strong women who have sub muscular implants where their chest muscles are so strong that it distorts the shape of the breast.  The muscle defines the shape of the implant versus the implant defining the shape of the breast.  These women are best served by converting from sub muscular to the Brazilian preferred method of sub fascial to correct this problem. You should talk to or see a board certified plastic surgeon to discuss your options.

Asymmetry after surgery.

We know your implants were identical, so if we can be certain of the correctness of your pre-operative assessment (that your breasts "were even"), then the only possible remaining reasons for asymmetry must be swelling or placement.

But your breasts weren't really perfectly symmetrical--you were simply unaware of any natural asymmetries (like your heart on one side of your chest and not on the other, causing the left chest wall to be curved, narrower, and more projecting, and the left ribs flatter, wider, and less projecting). This would have been identified by pre-operative measurements. Things that look symmetrical almost always measure slightly "off."

Added to these normal anatomic asymmetries are those aggravated by being right- or left-handed, and the asymmetric musculature that naturally results from that.

Plus surgical swelling differences, one implant being slightly higher than its counterpart, and even the differences caused by sleeping slightly more on one side than the other, and what you are seeing is not only NORMAL, but expected!

For one month post-op, you look splendid, and your breasts are beautiful. They will only improve as healing goes forward, assuming you don't "mess things up" by wearing the same push-up bra each day (could cause uni-boob and pockets closing off laterally, giving "wall-eye" nipples), or by going braless and causing bottoming out or double bubble.

Healing (COMPLETE healing) takes 6-12 months, and you need to be doing the right things to improve the asymmetries you presently see, even if no one else can appreciate these subtle differences. Don't be confused--you look perfect for this point in your recovery. You're simply not at the endpoint yet! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 239 reviews

What could cause my right breast to look smaller and have less projection? Both were even prior to surgery

Thank you for your question. You have very good result. They will continue to change in the coming few weeks.None of the two breasts look exactly same in most of the women. Please follow instructions from your PS

Great Result

You have an excellent result.  No two breasts are exactly the same - remember they're sisters and not twins.  I suspect that given a few more months you be extraordinarily happy.  Sometimes patients are over critical.  Give it some time. 

Post op

It is still very early and I think things look great for just one month.  Give it some time and I bet you will be happy in a few weeks.  Best wishes.

Jules Walters, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 45 reviews

Breast Augmentation - Post Op Swelling

Thank you for your question. You are still very early in the post-operative period. It typically takes 3 - 6 months for the swelling to subside and and implants to settle into proper position. The implants may swell asymmetrically, as in your case, but usually settle evenly. Please discuss your concerns with your board certified plastic surgeon. Also, make sure you follow all of your plastic surgeons post-operative instructions regarding level of physical activity and use of a support bra. Hope this helps and good luck with your recovery.

Healing process

At only 4 weeks, it is still early in the healing process after breast augmentation and some asymmetry is to be expected. As the implants soften, settle and drop the breast shape will change. It can take 4-6 months to see your final results. Be sure to keep any scheduled follow up appointments you have with your surgeon for his or her evaluation and advice. Good luck!

Dean Vistnes,M.D.
Vistnes Plastic Surgery
San Francsico Bay Area

#realself #breastaugmentation #drdeanvistnes

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast augmentation - now breasts don't match

Thank you for asking about your breast augmentation.

  • You appear to have a very nice result.
  • I suspect that the asymmetry was present before surgery - but you didn't notice it
  • See your surgeon for a 6 week check - and ask to compare your before/after photos.
  • We are ALL more asymmetric than we realize - and we ALL tend to notice it after surgery.
  • Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

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.