Would like opinions about my first surgical consult with a plastic surgeon in California. (Photo)

Need a lift along with implants to fix my breast asymmetry. Dr. recommended removing breast tissue from the larger breasts before placing the implant. I tried 400 cc implants and liked the result but I preferred silicone over saline. I was told I would get the best symmetry from a saline implant but my concern was how my breasts would feel after surgery. I was told that with my existing breast tissue if saline implants were placed behind the muscle I could still achieve a natural look and feel.

Doctor Answers 8

Would like opinions about my first surgical consult with a plastic surgeon in California.

Hello dear, Thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone soft cohesive implants, you can do a reduction on the larger breast of course, and then place the implant, every surgeon has it's own manners to perform a procedure. Hugs!

Dominican Republic Plastic Surgeon
4.5 out of 5 stars 397 reviews


I agree that the recommendations are certainly sound and reasonable. Done well, you could expect a nice result. I also agree that there would be little meaningful difference between saline and gel in you because of the amount of your natural breast tissue.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 79 reviews

Breast asymmetry

You start with a rather complex breast asymmetry, and the plan your surgeon outlined seems a sensible one. The advantage of saline implants would be that they can be overfilled to different extents, adjusting the difference in volume between the breasts. The disadvantage with them is that, simply said, silicone implants are far superior in look, feel and lifespan. I would recommend to use silicone implants, as I don't think the benefit of adjustable volume outweighs the significant downsides of saline implants.
You may also want to give a thought to staging the procedure in two steps: uplift first, then implants. This approach is slower and more expensive, but it will give you the best chances of a good final result. It is possible to combine the procedures together, but the correction would be less accurate and the risk of revision pretty high (20% or more).

Ciro Adamo, PhD, MD
Italy Plastic Surgeon
5.0 out of 5 stars 18 reviews

Breast asymmetry

From the look of your photos, if you're my patient I would reduce and lift the right side to match the volume of the left and then put to similarly -sized implants. The only reason saline is being recommended is that it gives you the option of adding more to the small side and better correcting the asymmetry. That small advantage I think is outweighed by the collapse of saline implants in the upper pole if properly filled. I would recommend gel implants because they look better, feel better and last longer. Hope that's helpful. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Saline Implants and Symmetry

If I understand you correctly, you are planning to get a lift on the larger size with implants in both breasts and you are concerned about the feel of saline? In my experience, the type of implant will not affect symmetry so I would encourage you to go with the type that feels best to you. Most patients find silicone more natural feeling. Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Would like opinions about my first surgical consult with a plastic surgeon in California

The type of implant will have no influence on the amount of symmetry able to be achieved. I think the natural feel that one wants varies from patient to patient although in my opinion silicone feels more natural, but both silicone and saline will give you the same shape.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Breast asymmetry

 The right side is quite acceptable. Consider doing just a formal reduction and lift on the left side getting you as close as possible. This would be the simplest approach. You could always put in a small implant if necessary on the right side at a later date. Good luck with your decisions.

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.8 out of 5 stars 25 reviews

Would like opinions about my first surgical consult with a plastic surgeon in California.

Thank you for the question and pictures.  Your concerns regarding breast asymmetry are certainly understandable.  If I were seeing you in my practice I would likely recommend:

Achieve a long-term stable weight if you are not there already. Then, proceed with breast reduction/lifting surgery to achieve as much breast symmetry as possible. Then, if you desire to increase breast size, undergo breast augmentation surgery at a second stage.

I hope this, and the attached link dedicated to breast asymmetry concerns, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

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