Can U Tell Me Why my Breasts and Areola Are Different Sizes? (photo)

Hi I have recently had a bilateral mastopexy to fix a previous breast enlargement. Before my recent surgery my breasts were the same size my problem is that after my recent surgery my left breast is noticeably larger than my right one and so is my areola on that side. Can u please advise when I will be able to have this corrected as it has only been 8 weeks since my surgery and also if anyone has any ideas how this has happened. Thanks

Doctor Answers 5

Breasts and Areola Are Different

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From this single photo, I certainly can see the difference in the areolar sizes, but not too much else with certainty. It may be that there is a size difference in the breasts, but I cannot discern it in this photo. The whole photo looks a bit tilted.

As far as overall breast size, it may be a bit early to assess anyway, although I can't tell from the narrative if this operation was just a lift or if something was also done with the implants. Swelling varies from one side to the next, as does the pace of relaxation of the pectoral muscles under which the implants usually lie. 

It is hard to imagine that these two areolas weren't marked with the same marker to the same size, but that does not assure that the final outcome will by the same size. One thing that I see occasionally is that just touching the first areola with the marker causes the other to contract, and the same size marker may result in a larger areola on the second side despite care to get them as even as possible. The good news is that after all has settled (allow 6 months) it would be an easy fix usually under local anesthesia to either reduce the size of the larger areola or to enlarge the smaller one, depending upon your preference. 

Thanks for your question and best wishes. 


Seattle Plastic Surgeon

Variation in breast size and areola diameter after breast lift.

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At 2 months your result looks quite good, though I do appreciate your concerns and see the discrepancies described. Size could simply be swelling or a reflection of you own natural breast asymmetry. I suspect the same surgeon marked and performed the surgery on both breasts, so the most common answer to post-op asymmetry is difference in bruising, swelling, and scar tissue. There could also be a small collection of fluid (serum) or blood that has not reabsorbed and could be aspirated. If this persists long-term, taking a bit more tissue from the large side is easily performed under local anesthesia.

Areola symmetry is frequently a hard thing to achieve. Skin is stretchy, and the surgeon cannot both hold the tissues taut AND make the cuts. S/he has to rely on assistance for this step, and once cut, it is notoriously hard to recut for improvement (at the initial procedure). I operate with the same nurse assistant (in my own AAAASF-accredited on-site surgical facility) I have been privileged to work with for many years, and we usually get it right, but this may not happen in a hospital or surgicenter where the surgeon works with a different crew, resident, or nurse assistant every time.

Once your breasts have healed, stretched, and scar tissue matured for 6-12 months, the larger areola can be reduced (again under local anesthesia, in most cases) to better match the other side. Don't be too hard on your surgeon; this is a good result, and the "fix" for a better result is not too big a deal! For several example of my own breast lift patients and their scars, click on the web reference link below. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Breast asymmetry following mastopexy and areola asymmetry

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Hi.....If you had only a lift and no removal of breast tissue, then you only had the volume of the skin removed.  It would therefore not cause a size discrepancy if it was only the removal of the skin.  A preexisting size difference would have had to be present.  As far as the areolas are concerned, I will assume that you have no stimulation or other cause for contracture of the areolas.  In the normal state, if the areolas are different in size, then they can be corrected quite easily.  You are only two months away from your procedure so I would have you wait at least 6 months or more to do a revision.  Remember too that no procedure is without the possibility of a complication so do not take a revision lightly.

Breast Asymmetry at 2 Months after Breast Lift

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   Breast size discrepancy should not be affected by a breast lift as only a few grams of skin are removed.  The size disparity may have existed before surgery.  Wait 6 months and then consider revision.

Breast asymmetry

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Remember no two breasts are exactly the same.  But I do see the differences you describe.  A revision is something if considered should wait a few more months. It is still too early.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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