Should I consider correcting asymmetry 2 years post op? 240cc implants (photos)

Question

I had breast Aug 2 years ago. I was a deflated b after breast feeding and also had asymmetry. We discussed using 2 diff sized implants 300/340cc for a natural result. After the op she told me she used 240cc both sides. I never asked why she didn’t use 2 different sizes as discussed. Now I am somewhat bothered by the asymmetry. I feel bad I never said anything. Should I fix this or let it be?

Jonathan Landon, MD · Answer

Hello and thank you so much for your question! If you're dissatisfied with the results of your breast augmentation 2 years post-op and are looking to correct the asymmetry, then you should absolutely seek out having a revision. With that said, we obviously cannot tell you whether or not you NEED a revision. If the only issue you're experiencing is aesthetic, and you are not having any problems that would impede your health or day-to-day life, then it has to be a decision made by the individual patient if a revision is the right move. Hope this helps!

Jeffrey Lisiecki, MD · Answer

If you are bothered by the asymmetry, then it can be improved with differently-sized implants and/or fat transfer.  While no one's breasts are perfectly symmetric, they can be made closer than what you have now!

Daniel Barrett, MD · Answer

Dear Alice3784,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

If this issue is bothering you, then you can certainly return to your surgeon to discuss even though 2 years has passed.

Sean M. Bidic, MD · Answer

It really depends on how much it bothers you. You have a nice result, but I see the asymmetry that you mention. A larger implant on the left would likely balance the breast better. I would like to know the nipple to fold measurements as well as seeing a lateral view picture. It appears as though you have more glandular ptosis (droop) on the right side. An larger implant wouldn't necessarily solve those issues.

Camille Cash, MD · Answer

You are really the only one who can answer this question.  If it is bothersome to you, then exchanging the implants can get you better symmetry.  If it isn't very noticeable in clothes or not particularly distressing, there is no need to change it.

Connie Hiers, MD, FACS · Answer

If the difference bothers you, and I suspect it does since you wrote about it, go back to your surgeon and discuss your options.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment regarding the outcome of any plastic surgery procedure, we need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
They are part of your medical record that you can request at any time.
While you’re at it, you should also get a copy of your operative report, which may mention something about implant selection.
Breast augmentation outcomes are generally based on three variables.
The first is the patient’s candidacy for the procedure in the first place.
Not everybody is an ideal candidate for breast documentation.
Things that can alter someone’s candidacy for breast augmentation include breast shape, nipple, position, or breasts ptosis, breast position on the chest wall, asymmetry and breast divergence.
Most people have the left breast sitting slightly higher on the chest wall than the right side.
This is true for both men and women.
It would be helpful to know if your implants were replaced above or below the pectoralis muscle.
Your arm position also changes what your augmentation looks like.
We generally do assessments with patients keep them their arms down by their side.
If you like your current provider, then follow up with her.
I think it’s a little late at this point to request a revision operation to be covered for free, but it doesn’t hurt to ask if you feel confident with her skills and ability.
If you want a second opinion consultation, then schedule that as an in person consultation with other plastic surgeons in your community.
For second opinion consultations, come prepared bring with you a complete set of proper before and after pictures and the copy of your previous operative report.
If you’re outcome bothers you enough that you’re willing to have an operation then you should either follow up with your provider or schedule second opinion consultations.
It’s not for us to decide. Without knowing what you look like before surgery, we can’t really make a quality assessment regarding the outcome.
If your current outcome is based on 240 mL implants then be glad you don’t have 340 mL implants. 
You do have slight a symmetry, but so do all women and you’ve had a symmetry all of your life
There may be room for improvement in regards to the overall outcome, but I think you deserve quality assessment and for that we need better information.
Best,
Mats Hagstrom, MD

George Lefkovits, MD - Account Suspended · Answer

After looking at your photos i see a few issues regarding your breasts. While your left breast seems slightly smaller, the inferier border is also a bit highere. Also you can demarcate the upper border of both breast beacuse of a sharp demarcation. These features results in some asymmetry but also, more importantly, result in the breast appearing artifial and not natural. The correctio would entalil doi8in g what is called an open capsultomy, wheby the envelope around the implant is opened which allows the implants to assume a more natural configuration, as well as correct the higher inferioer border of the left implant. Finally, it may be necessary tc change the sizee of one of the implants. You should either return to your plastic surgeonconsult with ab Oard Certified plastic surgeon with lots of experience performing braest augmentation Good luck!

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