Asymmetrical nipples after breast augmentation. Is this my fault? (Photo)

Question

Before my breast augmentation, my nipples were slightly asymmetrical, but barely noticeable. After, they look very symmetrical and it’s very upsetting. My doctor tells me that it’s my fault, but I have no idea how. My breast are also slightly asymmetrical with my right one being higher than my left. Is this my fault?

Jeffrey M. Darrow, MD · Answer

Thank you for your photographs. Your postoperative photograph shows that your left implant sits higher on your chest, and therefore it gives the appearance that your left nipple sits lower. The solution to this is to lower the left implant so that the bottom and top of your left implant is at the same level as your right side.  Ask your plastic surgeon if they would do this small revision to keep you as a happy patient. Best wishes.

Leila Kasrai, MD, FRCSC · Answer

Implants tend to make shape asymmetry more visible. However, in this case it looks like you may need to speak with your surgeon about a possible revision as right side (in the photo) seems to be sitting higher.

Daniel Barrett, MD · Answer

Dear Rational264784,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! I'm not sure that it is anyone's fault. It appears as though you may have capsular contracture on the one side and that is causing the implant to ride high and makes that nipple look lower. I would suggest an in person appointment for the best remedy. Good luck!

Matthew C. Camp, MD · Answer

It is a known risk with breast augmentation that placement of implants can enhance any asymmetry that is present before the procedure. I agree that your asymmetry prior to the procedure is minimal. On review of your post surgery result, your left implant is positioned higher than the right, resulting in the left areola and nipple appearing to be lower on the left breast. In this case, it is the person who placed the implants responsibility to correct the implant malposition. I always include the discussion of the risk of asymmetry with breast augmentation - it seems you may not have had this information relayed to you prior to surgery. Best wishes with perfecting your augmentation result.

Gerald Minniti, MD, FACS · Answer

It is not your fault. Your lower nipple is over the implant that sits higher. It's an implant malposition issue.

Tek Przylecki, MD, FACS · Answer

From the preoperative photos, it appears that you have noticeable breast asymmetry with the left breast being smaller and the nipple being a little more lateral with a higher inframammary fold. In general, breast augmentation will accentuate the nipple asymmetry. That being said, it appears that the left implant is sitting higher.How long ago was your surgery? If it was recent, there is potential that the left implant drops a bit would improve the downward positioned nipple.If it has been a number of months, this is less likely to happen. Surgically lowering the inframammary fold and allowing the implant to drop would position the nipple in a more favorable position. I hope this helps answer your question.

Zoran Potparic, MD · Answer

It is impossible to see your areola/nipples before surgery on this photo, unfortunately. However, providing that your surgeon did not use incision around areola for breast implant placement, current asymmetry is entirely due to skin stretch caused by implant size. In other words, small pre surgery asymmetry becomes more noticeable after large implants. Hope this helps.

Camille Cash, MD · Answer

From the photos it appears you had some nipple asymmetry prior to augmentation but the appearance of the nipples today is influenced by implant malposition.  If you are early in your recovery you still may see improvement as swelling resolves and healing progresses.

Connie Hiers, MD, FACS · Answer

You do have one implant that is still sitting higher than the other side which will make the nipples uneven. Please discuss with your physician how to lower this implant. Wearing the breast band, taking oral Accolate, and doing external ultrasound treatments can all be helpful if you are past 4 months from surgery.  Keep doing your breast exercises to encourage the implant to drop. "Fault" is not the best word to use, but you do have two different breasts and use your arms differently.