25 y/o, 138lbs, 5’5 - do I need another revision or is it my anatomy? (Photo)

It would be helpful to see pre operative photos from before your first operation to assess your natural breast volume and nipple asymmetries. It would also be helpful to know which implants you have to see if your surgeon attempted to correct existing breast asymmetry with different sized implants. The differences in nipple position are likely natural and due to your anatomy. You also appear to have natural differences in breast footprint area, left being naturally wider than left. Differences in vertical nipple position can be corrected with a mastopexy or lifting procedure. Differences in horizontal nipple position are very difficult to change. Differences in natural breast volume can be improved with different sized implants.

Dear Polite924344,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You need to look at your before-any-implant photos to see exactly where your nipples sit and if they are symmetrical. This will answer your question. I suspect, you were not symmetrical.

The left breast does look larger, and the nipple position is also slightly different. It is possible that this is due to your anatomy, but without seeing the before photos it is difficult to tell. I am assuming you have the same sized implants in both breasts. If your goals is to increase the volume on the right, fat grafting might be an option. I would recommend you discuss your concerns with your plastic surgeon.

You are once case where I feel a physical exam would answer so much. The higher breast appears to have a different sized pocket dissection. The other breast shows a nipple/areola which is lower- this might require a mastopexy (breast lift). Pre-op photos would also help to diagnose what is going on.
Best wishes.
Dr. Taranow

From the photo it appears you have some nipple asymmetry. You have likely always had this but the augmentation has made it more pronounced. It can be corrected, but will require more surgery.

Your breast volume symmetry is pretty good, thought your left seems just a bit larger. The issue is your native nipple position. I suspect your preoperative photos show this too, but more noticeable now.

This can be improved with a lift but with the necessary skin incisions that may not be worth it to you.

Good luck.