Will I need a pocket revision and/or a larger implant? (photo)

I am 3 weeks post op and my left breast (380cc silicone sientra unders) feels/looks fuller than my right (350 cc silicone sientra unders). It is lower as well. I know my breasts were asymmetric prior to surgery. My ps advised to massage my right breast more but I feel that it is not going to help with my assymetry. Will I need a revision?

Doctor Answers 6

Will I need a pocket revision and/or a larger implant?

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It is too early to determine if you need a revision. You did have, and correctly noted yourself, asymmetry prior to surgery as well and each side can also act a bit differently during the post-operative period. Continue with the massage exercises and follow up with your surgeon as scheduled.

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Wait several months before deciding on revision breast implant surgery

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Asymmetry in the early post op period is often due to selling and other factors that will change with time. Wait at least 6 months before considering a revision unless there is a significant problem.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Implant Exchange with Mini Ultimate Breast Lift(TM)

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You have breast asymmetry and your nipples are pointing downward. Your implants are too large and you need a lift. After waiting for about 3 to 6 months, I recommend Implant Exchange with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. The nipples will be re-positioned so they match. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. At your operation, you only had an inferior areola approach and this was not adequate to correct the asymmetry. Implants alone only change volume, they do not change shape or position.

Best Wishes,

Gary Horndeski, M.D.


Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Will I need a pocket revision and/or a larger implant?

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It may be too early to tell for sure, as implants can settle over a few months. An implant can look higher because the pocket was not made low enough, or because a patient is developing an early capsular contracture (that tends to elevate the implant), or because a patient's breast was higher on the chest before surgery and some of this asymmetry has persisted. A breast can look larger because of more swelling, a collection of blood, or because a larger implant was placed when an implant of the same size might have been a closer match. I would suggest giving it a few months, following your surgeon's instructions, and reassessing whether a revision is needed.

Breast implants

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I actually think your breasts look great and you shouldn't make any decision regarding revisions for at least six months from the time of surgery. Asymmetry is common in breast surgery, but yours is of a very slight amount. Be patient!

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 30 reviews

Too learly to determine need for revision

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With the amount of asymmetry you started with you should keep doing as your surgeon directs. Keep in close touch. The pockets need more time to mature before you can determine how the implants will act. I would reserve any judgment until four months at a minimum.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

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.