Why Are my Breast Still Uneven Post Op After Four Months? (photo)

Question

My breasts are uneven post op after four months. I have 300cc silicone bilaterally implanted on May 17th 2012. As of today, it is still uneven looking like the left side has drop much more so than the right and that the size are also not the same. The left side still feel like is has fluid or air in it because every time I go to massage it pushing it toward the sternal area, I can obviously see the ripple and a creptitus sound is heard. Should I be concern or get it redone?

Farhad Rafizadeh, MD · Answer

Thank you for including a before picture that shows your symmetry.The post operative picture shows that the left implant is lower. The fold under the breast is also lower on the left side. That is why the left breast is less full in the upper pole area. The solution is to raise the left breast implant by a capsulorraphy or lower the right implant. Talk to your plastic surgeon about these options.

Ary Krau, MD, FACS · Answer

It does appear that your left breast is larger than then your right. Keep in mind that all woman have some breast asymmetry. Asymmetry is normal. The asymmetry could be from your rib cage, volume muscle. and breast volume aghernd shape. In your case, it appears that your left breast was a bit fuller pre-operatively. Also, left inframammary fold was higher before surgery. After surgery, your left inframammary fold is lower. This has exaggerated your asymmetry. Although, it is possible, I doubt you have a "seroma" in your left breast. An ultra sound can rule that out. I do not agree that your implants are too large. Although dimentional analysis is helpful, the size you chose is a personal one. I think that intra-operative sizers are the best tool to use when dealing with breast asymmetry. Although you can never be perfectly symmetric, I think your breast can be made to look much more even. You would need to wait a few more months and then undergo revision.

William Franckle, MD, FACS · Answer

Post operative issues such as yours are not infrequent following breast augmentation. Sometimes one side will settle earlier than the other leaving an uneven appearance which resolves or at least improves over time. However, with a very noticeable difference at 4 months, you should consult with your surgeon to see if this is just slow healing or another problem such as a seroma or fluid collection, pocket malposition, or an early capsule formation.

Gerald Minniti, MD, FACS · Answer

Hello,

	I am sorry you are having problems with your result after breast augmentation.  There are two things at play here that are conspiring against you, giving you your asymmetry.  First, your left breast appears to have been subtly larger prior to surgery. Second, your left breast implant has dropped lower than the right, filling the bottom of the left breast out and projecting the left breast more than the right. This combination accentuates the appearance of your left breast being larger.

	I would wait a full 6 months before revision surgery to see if there is anymore settling of either implant.  Based upon the appearance of your breasts then, you and your surgeon can plan the revision.  Possibilities include: 1. lowering the right implant.   2. raising the left implant.   3. combination of 1 and 2   4. Placing a larger implant on the right side (along with previously mentioned pocket adjustments).   5. Placing a smaller implant on the left side (along with previously mentioned pocket adjustments).  As you can see, the possibilities seem endless, that is why you need to wait to determine which path to follow.

	By the way, what you definitely don't need is a breast lift of any kind!!!

	I am sorry you will have to have a revision surgery.  25% of women have a revision surgery within 3 years of their original surgery, due to problems which includes the ones you are having.  Unfortunately, most of these complications are associated with implants that are too large for their anatomy, and could have been avoided if a process called dimensional planning was used to pick implant size.  Unfortunately, your photographs suggest that your implants (despite being 'only' 300cc) are larger than those that would have been chosen by dimensional planning.  You may want to reconsider your current size when you have your revision surgery.

	Best of luck!

David Shafer, MD, FACS · Answer

Thanks for posting pictures of your before and after.  If your surgeon put the same size implants on both sides, then there is something else that would explain the volume asymmetry.  Most likely you have a fluid collection or seroma.  If so, it can easily be detected by ultrasound and likely drained by ultrasound guidance.  Your surgeon should be able to set this up for you.

	 

	Good Luck.

Amy T. Bandy, DO, FACS · Answer

Based upon your pre-operative photographs, it looks as though you did not have any assymetry prior to your implants, which would warrant using the same size implants. If the same size implants were placed, and you are experiencing what you are, I would recommend seing your surgeon as soon as possible and requesting an ultrasound, as you might have fluid build up called a seroma within your larger breast. If confirmed, you would need the fluid drained. I would also recommend having the fluid sent to the lab to see if the fluid grows out any bacteria. If bacteria is present that could possibly encourage additional fluid collection or infection, I would immediately place you on an antibiotic for that specific bacteria growth. I wish you the best of luck!

Remus Repta, MD · Answer

Hello,

	Thank you for the photos.  Size asymmetry can be caused by pre-operative asymmetry not corrected, different size implants used during surgery, seroma/hematoma, or capsule contracture.  If your breasts have not gotten progressively harder then capsule contracture is not likely.  Your preop photos show good symmetry.  The most likely source of your asymmetry would seem to be a possible seroma.  This would be even more likely if the size of the larger breasts seemed to increase with time during the post-operative period.

	All the best,

	Dr Remus Repta

Steven Wallach, MD · Answer

Yes, there is a difference between the two breasts.  Some of this may be due to fluid .  Hard to say without an exam, but I doubt it will get better on its own.

Darryl J. Blinski, MD · Answer

For visual asymmetry the correct could be a donut lift on the right side. But best to seek in person opinions.

Tal T. Roudner, MD, FACS · Answer

As stated below and in your description you may have a fluid collection also called a seroma. It maybe confirmed by ultrasound and may need surgical drainage. See your surgeon as soon as possible.

	 

	Good luck!

Why Are my Breast Still Uneven Post Op After Four Months? (photo)

Answers (13)

More Breast Implants Questions

Can I Swim Regularly in Cold Cold Water with Breast Implants? Or is This a Rupture Risk.

How Much Would It Cost to Get Breast Implants in Ontario?

My Doctor Told Me Not to Massage my Subglandular Implants. Is He Right or Should I Massage Them?

600cc Implant On My Frame?

How Many Cc's to Achieve Perky Size D?

WE SEND PRETTY
EMAILS