Planning on Breast Aug with Lift, If I Get Silicone, How Will They Make Them the Same Size?

My right breast is slightly larger than my left. I was planning on getting saline, but I've been researching more and the silicones are safe as well. If i were to get silicone, how does it work to make both breasts the same size? What method is used for this type of case?

Doctor Answers 18

The Management Of Asymmetry In Patients Having Breat Augmentation With Breast Lift

It's not unusual for patients who have breast hypoplasia and associated breast sag to also have breast asymmetry. In the vast majority of cases, this asymmetry is relatively minor and would be considered almost normal. However, in some cases, asymmetry can be severe and require surgical correction.

Correction of asymmetry can be accomplished with a variety of surgical approaches. In some cases, saline implants can be differentially filled to correct asymmetry. In otherĀ  cases, different sized silicone implants can be utilized. Finally, small amounts of breast tissue can be removed to adjust breast size and shape.

It's important to realize that no two patients are ever exactly alike and for this reason, the approach to asymmetry needs to be individualized. When silicone implants are used and minor asymmetry is present, small adjustments can be made by removing small amounts of breast tissue.

It's important to realize that symmetry is one of the primary goals of cosmetic breast surgery. If you're concerned about this symmetry, it's important to discuss the issue with your plastic surgeon. Your surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Symmetry after breast lift and augmentation

Combining a breast lift with breast augmentation is your best chance at achieving symmetry.  However understand that all women have a slight asymmetry and you will likely have a slight asymmetry no matter how hard your surgeon tries to make the position of your nipple areola the same.

It really does not matter whether you have silicone gel or saline breast implants however the fact that saline implants can cause rippling  causes most patients to choose the silicone implant.  Please discuss this with your plastic surgeon.

For more information on combination breast lift with augmentation please read the following link:

Choosing Silicone over Saline shouldn't matter when a Breast Lift is involved.

When a breast lift is done, there is usually more involved than just elevating the breast gland in position, especially when an implant is involved.  In order to achieve an aesthetically ideal result some tissue is removed in order to "sculpt" the breast over the implant.  Although the removal is usually very minimal, different amounts can be taken away as needed.  Therefore, unless the assymetry is extreme, one doesn't need to (and, in fact, shouldn't have to) adjust the volume of the implants from one side to the other in order to correct the assymetry and you can choose whatever implant type you're comfortable with.

Complete symmetry can be elusive

It is very important that you and your plastic surgeon agree on any asymmetry before surgery. Although one advantage with saline implants is the ability to "fine tune" the volume/size at surgery by adjusting the fill volume, asymmetry can also be adjusted by choosing slightly different sized (pre-filled) silicone gel implants. Also, as you are having a lift, some adjustment can be made by removing slightly different amounts of breast tissue. Through these two techniques your surgeon should be able to minimize any further differences between your two breasts, but remember that perfect symmetry is rare!

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 67 reviews

Asymmetric breasts in augmentation mastopexy

One major problem with augmentation and asymmetry is the inability to measure exact volumes of the breast before and after surgery. External sizers or internal sizers at the time of surgery are very inexact and potentially misleading. One of the advantages of the saline-filled breast implant is that the volume can be adjusted by up to 10% without overfilling and this can offset the volume needs from one side to the other without varying the width of the implant. Silicone gel-filled implants do not allow for adjusting volume and a larger implant on one side will also have a wider width which is not good for symmetry. 

In general, if a lift is truly needed then it shouldn't be much additional surgery to remove a small amount of tissue from the breast of the larger side although the knowledge of how much to remove is also quite subjective. Down the line, it is better to equalize the tissue of the breasts rather than do it with different size implants as the breasts will age and change with hormones or weight more equally with equal volume. Fat grafting is still not a well established and known to be risk-free option for cosmetic breast adjustment. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Breast symmetry and breast surgery

Either a different sized implant could be used, or an amount of breast tissue equal to the difference in size of your breasts can be removed from the larger breast. Either option would be useful to return you to better symmetry. 

Richard J. Beil, MD
Ann Arbor Plastic Surgeon
4.9 out of 5 stars 14 reviews


Your surgeon can use different size implants, reduce the larger breast or a combination of the two to improve symmetry.  No procedure will allow them to be perfectly symmetric but much closer in size.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 42 reviews

Silicone implants and asymmetry

Silicone implants are not adjustable and are available in 20-50cc increments depending on the size and manufacturer.  You may have a small amount of post op asymmetry.  There are several ways to determine how much asymmetry you have.  Silicone bra inserts are available in your plastic surgeons office to help you decide on implant size.  You can also use the “Rice Test” at home.  These two methods may help your surgeon get you close.  In surgery, your plastic surgeon can use a sizer (placed under the breast temporarily) to help him or her decide the correct choice of implant.

D'Arcy Honeycutt, MD
Bismarck Plastic Surgeon
4.6 out of 5 stars 20 reviews

Correcting asymmetry with different sized implants.

Different size implants can be used to correct asymmetry.  Fat grafting is another option.  A breast reduction on the smaller breast is also an option.  An exam is necessary to determine which procedure can help you meet you goal. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Correction of asymmetry during lift augment

The two ways to correct asymmetry in this case is to put in different size implants or to remove some breast tissue from the larger side. I have found that when performing a breast lift and augmentation at the same time the results are much better when some breast tissue is removed from the lower part of the breast. The breasts will always be different from one another, (they are sisters, not twins), so if you have the same size implants in each breast then you at least are assured that it is not the implant size that is causing the difference and modifications can be made to the actual amount of breast tissue.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.