Nipple Asymmetry After Breast Augmentation? (photo)

Question

Hello, I had breast augmentation surgery done few weeks ago, and I can notice a difference in the breasts, my left breast is more higher, the upper part is more full, and the nipple is looking down, not like the right breast. What could be the reason? How would I know if it's not due to seroma or hematoma, how can I check for that? Before surgery I never had asymmetry. I had 350cc in both breasts.

Jed H. Horowitz, MD, FACS · Answer

You do seem to have nipple asymmetry following your recent augmentation. Yet, it is still quite early into your healing and the final results are yet to be seen. Usually it is suggested to wait six to twelve months for a breast revision or additional surgery as the final result may still yet to be seen. Creating a #Neopectoral #pocket is sometimes used as a technique to provide a stronger more secure placement for breast #implants. In this case, the implant is removed and the capsule is dissected from the muscle to create a new or “neo” pocket for the implant. However, any #asymmetries regarding the folds under the breasts may not be totally corrected from one revision procedure. 
To better determine the technique and if a revision will be necessary, I suggest you see your board-certified surgeon to discuss in more detail. Meantime, it's best to remain patience while you heal and continue to communicate these concerns with your surgeon and their nursing staff.

Naveen Setty, MD · Answer

Without pictures or a physical exam, it is difficult to tell if there is a fluid collection in your breast. If your surgery was done recently, breast asymmetry is very common in the early postoperative period. Often, one breast implant will settle sooner than the other implant. Eventually, they both reach a similar level and that can take at least 6 weeks in some patients. Sometimes, it can take longer. If you are concerned, make sure you follow up with your surgeon to ensure that a more significant problem is not present.

Leonard T. Yu, MD · Answer

From your photos, your nipples appeared symmetric prior to surgery, but the lower folds were not, your left fold was higher than your right. In the most recent photo, this is still the case. It seems that the nipple asymmetry you have now is due to the left implant being higher than your right and causing your left nipple to point down. This may improve with the skin relaxing more on the left, implant displacement exercises, a stabilizer band, more time for healing, but may be revised by lowering the fold if it does not improve over several more months.

Jourdan Gottlieb, MD · Answer

I can see what concerns you. Thanks for attaching the series of photos which are most helpful.

	Although the breast look quite even before surgery, the chest muscles underneath are rarely even is size and strength, and it is that that frequently contributes to early post-op asymmetry. One muscle is often tighter, pushing on the implant more than on the other side and causing the fluid to bulge in the upper pole. Almost always if the implants looked even in surgery they will look even after the implants settle and relax to accommodate the implants. This usually taked 3 months, sometimes longer. You probably wouldn't be able to recognize a small fluid collection, but your surgeon could. Any reassurance from those of us looking at photos pales by comparison to that from an in person evaluation from  your surgeon.

	 

	Thanks and best wishes.

Pedro M. Soler, Jr., MD · Answer

The absence of photos or an examination makes it difficult to give an accurate opinion. However, you are fairly early in your recovery period. At this stage there will be swelling and scarring that it talking place in your operative site. Your breasts need to heal. It will typically take 3 to 6 months to see your final results and in some women longer. During that time the swelling and the scarring process will start to subside and the soft tissues will start to accommodate allowing the implants to move into position. It is important to understand that these processes may not occur at the same time in your breasts. If that is the case, then you will have some asymmetries that should hopefully correct in time.

	I would recommend that you continue close follow up with your plastic surgeon and make sure you voice your concerns. They are in the best position to help you at this juncture, as not only did they do the surgery, but they have been monitoring your recovery.

	I hope this helps. Good luck.

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