I Am Having a Re Op Due to Uneven Result What Are my Options? (photo)

I have a scoliosis of the spine that effect my chest wall I had a BA 5 months ago my surgeon advised left 330cc moderate profile and 345cc high profile soft touch textured. My left breast is bigger and fuller my surgeon wants to down size to a smaller implant I also have a little rippling of the left breast. I would like the right made bigger. Would like some input from other surgeons on what course would be best to take. Also will smooth implants be better for me.

Doctor Answers 13

Revising augmentation with scoliosis

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There are so many issue that must be considered in your situation.  You already expressed a desire for improved volumetric symmetry and that will involved either downsizing the left or upsizing the right... you look generous already and my preference would be to downsize.  But by how much?  One size or two or more?  Then are you desiring level upper poles in spite of your scoliosis or angled poles to match the curvature of your spine?  Since you are looking at a revision, make sure everything you wished could be better is addressed.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast asymmetry

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Symmetry or close to symmetry is difficult with marked asymmetry in size and scoliosis. If you want to match the larger left breast, then I would take out the 345 high profile .and try to match the left breast with sizers. It might take a moderate profile 450 implant to achieve closer symmetry but that is a guess. Once the implant closest in size to the left implant is in place, then move the left nipple-areolar complex a little more medial to lessen the affect of the scoliosis.

Terry A. Cromwell, MD (retired)
Lafayette Plastic Surgeon

Scoliosis and breast implants

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Scoliosis will make the chest wall uneven and this can create issue when planning breast augmentation. The issue will be that a perfect balence will be difficult to achieve and that the best option for that would be the at the first operation. At the revision I would consider downsizing, and using a smooth implant in the now large pocket, " the mega pocket technique".  Your case is not a simple one and you will need a clear plan with clear objectives before surgery.  I suggest a thorough discussion with the surgeon before any revisional surgery.

All the best

Jeremy Hunt  

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Implants and scoliosis

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WIth scoliosis, the underlying skeletal structure will be different.  In general, patients do not have symmetry of the breasts. Certainly the implants could be adjusted to better match the volume but they will never be the exact same.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Texturized implants more likely to generate rippling. Period

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There are a lot of considerations for the asymmetrical breast results. I see no benefit in using texturized implants ever.

I Am Having a Re Op Due to Uneven Result What Are my Options?

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Understand over the internet very hard to be exact. I might increase volume of the right breast either with larger implant or fat grafting or both. As for the left breast I recommend a lifting operation. Good luck. BYW your stage 1 result is very good!!!! 

Revision of Breast Augmentation

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Thank you for your pictures. You certainly can go either way. I would recommend upsizing the left implant if you wish to be bigger. I am not sure why used textured implants. Silicone implants beneath the muscle will work fine. This may help resolve some of your rippling problems. You would also need a revision of the right breast to decrease the distance between the nipple and the fold.  

Dr. ES

Uneven breasts 5 months post-op with scoliosis

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It is very difficult to obtain symmetry in patients with scoliosis or other chest wall irregularities, as it is often not an issue of volume or even dimensions of the implants or breasts themselves that is the obstacle, but the projection and shape of the rib cage and sternum that affect the position and projection of the implants.  Each patient is different, and as such these are complex problems, I don't think we can adequately advise you on the particulars of your case in a forum like this without a physical exam.  The one bit of advice that I can offer however, is that as someone with experience with textured shaped and round implants as well as smooth round implants, I would not suggest using shaped implants in a case like this.  The risk of irregularity is just too great.  This is because not only do the shaped implants have a smaller margin for error because of the definite long and short axis and the very specific vertical positioning that is required for each implant to look its best, but they are made of a firmer gel, called cohesive gel, which makes them hold a very specific shape against the chest wall no matter what the body position.  This is in contrast to the softer smooth round gel implants in which the gel conforms better to chest wall irregularities and has a better chance of camouflaging them by draping over the firm bony irregularity instead of amplifying them by stiffly sitting on top of it and projecting irregularly from it.  Best of luck to you.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

For better symmetry?

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Hello and thanks for your post. It seems reasonable to have both options - bigger on the right and smaller on the left. There are pros ans cons between those options, but not downsizing your left will cause the rippling to persist. That might not be a bad price for having improved symmetry. Talk some more with your PS and then decide. Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 215 reviews

Breast asymmetry

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You have quite asymmetrical breasts due to both the scoliosis and also due to differences in size and shape of your breast tissue.  Your surgery has helped this and your result in a bra is quite good.  To try and improve symmetry further is difficult but I agree that perhaps making the right side a little bigger would be preferable to making the left smaller.


Kind regards,



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