Why Would a PS Choose to Put a 500cc in One Breast but Only a 450cc in Other..

I just had BA done about 2 weeks ago. I had BA revision done from a BA 10 yrs ago (250cc silicon implants). My right breast was bigger then my left before this recent surgery. I asked for 475cc implants this time. Looking at my breast just after the surgery I could tell the left one was still smaller. My implant cards show 500cc in right and 450cc in left. Why would I get a smaller implant in an already smaller breast to begin with? To me a 50cc difference seems like that would be noticeable.

Doctor Answers 10

Breast revision

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It looks like your breasts are pretty even in your 2 week photo. Bottom line it's only been two weeks. I'm guessing your surgeon put those sizes in because he felt they made you the most even. But this is a quesiton only your surgeon would be able to comment on. The right breast may have been more swollen then the left in the 5 hour post op photo, but if they stayed exactly the same as your 2 week photo several months from now I think it's an acceptable result.

Beverly Hills Plastic Surgeon
4.6 out of 5 stars 106 reviews

Photos show preexisting asymmetry but volume not easily evaluated

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Your photos definitely demonstrate well asymmetry in your breast.before and after surgery. Asymmetry may result from either your breast envelope being "relaxed" ie with ptosis or from your left breast having a smaller volume. In your photos we can conclude you have asymmetry as well as ptosis but cannot comment on volume without a physical exam. Since the asymmetry has mildly improved after implantation with a smaller implant on your left, It is very possible that your left breast may not have been smaller in volume prior to surgery. It might be worthwhile to have an open discussion with your surgeon about your situation. If his/her explanations do not adequately address your concerns consider seeking another opinion from an experienced surgeon. All the best to you.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 21 reviews

Using different sized breast implants to address breast asymmetry

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Looking at your photographs,  you appear more symmetric at 2 weeks post-op than you did at 5 hours post-op, suggesting that some of the asymmetry that you see may be the result of immediate post-operative changes - fluid around the implant, swelling, etc., and that you may still improve further with time.  Correcting breast asymmetry with different implant sizes can be very difficult, because the extra volume in the implant may not be positioned where you need it in the breast.  This is definitely a situation that you should discuss with your surgeon, to find out why those particular implants were selected.  You should also confirm that the implant cards were marked correctly, as there is also the possibility that the incorrect sides were marked on the cards.

Good luck.

Craig S. Rock, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

30cc's about 1 ounce

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Keep in mind that 30 cc's is about 1ounce which is about the amount of liquid in a shot glass. So when one talks about 50 cc we are not talking about a large difference but it can make a difference since the larger the implant volume the larger the diameter of the implant. I would recommend waiting about 3-6 months and then reevaluate the situation. If you feel there is a significant difference, talk to your surgeon about replacing the implant with another size.

Albert Dabbah, MD
Boca Raton Plastic Surgeon

Brest augmentation

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Many patients are asymmetric and can benefit from different size implants in each breast. This is very common

David L. Abramson, MD
New York Plastic Surgeon

Why Would a PS Choose to Put a 500cc in One Breast but Only a 450cc in Other..

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Thanks for the photos posted. Looks like a error in size placement was made. You can demand correction, I would. Or try for a 50% refund and go to another boarded PS. 

Only your surgeon will know for sure

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Implant size take good judgment and experience. It takes much more that picking a number. If you perceive size and volume discrepancy in your breast augmentation discuss it carefully with your surgeon. If the last photo is 'you' after your revision, things look pretty well overall.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast implant size trade offs

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There are many factors that contribute to choosing the volume of an implant at the time of surgery.  The factors include the patients goals, the starting volume and the starting skin of the breast and the thickness of the chest wall muscle.  Sometimes the chest wall is asymmetric and this has to be taken into account as well.

 Volume and skin are not the same thing.  A breast may look larger not because it is bigger, but because it is droopier.

In your photos the right breast is clearly droopier but it is hard to tell if it is larger.  I focus in the upper pole symmetry in a situation like this.  An implant alone will not solve your differential droop so at least we hope to make the upper  pole as even as possible. Your surgeon may have backed off the volume on the left to make the upper portion of the breasts look more even.  You should discuss it with him.  I often make these trade offs in my own practice.

A crescent or small mastopexy may elevate the right  areaola if this is what you are noticing.


Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Choosing the correct breast implant size

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Selecting the correct implant size is one of the most difficult challenges for the surgeon

This is because there are many factors thav have to be considered when selecting a breast implant

These include-

Existing breast size, breast shape,base diameter,symmetry ,chest wall asymmetry,scoliosis,breast ptosis

Patients desire for size and projection,findings and evaluation at surgery and post operative changes

Therefore sometimes volume changes are made at the time of surgery.

In difficult to size patients , I use the Saline adjustable implant ,which allows the size of the implant to be changed after surgery. A new adjustable gel implant has been developed whis is currently available outside the USA .FDA studies will be starting later this year and several centers will be offering thei implant as part of the study

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Differnt size breast implants are often necessary to achieve an optimal result.

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Breasts are often asymmetrical, with one breast being of a different size and/or shape. Your plastic surgeon will take this disparity into consideration. Often this requires that he use different size implants to make the two breasts as similar as possible. This is often discussed before surgery with the patient.

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.