Asymmetrical breasts 1 year post op - What could have caused this? (photo)

Question

Its been a year that i got my breast augmentation but ever since, i experianced more pain/muscle spasms on my left boob. However now after a year i noticed my right breast is nice and perky while my left kinda dropped to the side, is this normal or should i consult my surgeon. Did my surgeon not do my augmentation right? I hate how my left boob just looks like when you grab a water baloon from the top, i have hardly any definition on the top, rather than the right is nice perky and round.

Christine DiEdwardo, MD · Answer

Thank you for your question. It is common to have asymmetry following breast augmentation surgery. The chest wall and breast volume/shape are not perfectly symmetric, and patients may notice these asymmetries more following augmentation surgery. There could be several other contributing factors to breast asymmetry following breast augmentation. A soft tissue capsule normally forms around breast implants and in some cases this capsule can result in differences in shape of the implants over time. Sometimes the breast implant can displace laterally as there is less resistance of the soft tissues in this location and in certain instances this can be improved with surgery to adjust the breast implant pocket with sutures. It would be best to discuss with your surgeon as he/she can determine what the reason is and if it is possible to improve the symmetry.

Robert M. Wald, Jr., MD · Answer

I would have to see your prop photos to give a more accurate answer. However, looking at your photos, I don't see any severe asymmetry. All breasts are asymmetrical to begin with and always are slightly different after surgery. One breast pocket is also different depending on the anatomy. If you have questions, please follow up with your surgeon.

Derek Fletcher, MD · Answer

Breast asymmetry after breast augmentation can have multiple causes. Breasts are almost always different to begin with. Even breasts that appear naturally perfectly symmetric are not if you look carefully. Natural breast asymmetry results from differences in soft tissue volume and volume distribution, differences in nipple position, differences in skin characteristics, and differences in chest wall shape (ribs and pec muscles). 
Surgical technique and implant selection can can sometimes improve symmetry if the reason for natural asymmetry is mild. However, even with volumetric 3D imaging to help with planning, it is very difficult to consistently correct asymmetry because there are so many causes of asymmetry and implants aren't necessarily made with a given individual's differences in mind.
Breast augmentation can make asymmetry worse if the surgeon makes a mistake in implant selection or creates a space that is not perfectly positioned and sized for the implant they use. 
To help figure out why your breasts are different I need to see your standardized preoperative photos, review your operative report, and see standardized post operative photos including from above with you laying down to see how much your implants fall to the side.
Final thoughts: your photo suggests you have an excellent overall result. Yes, your breasts are different, but the differences appear to be fall well within the normal range.

Zoran Potparic, MD · Answer

Only on the basis of in person evsaluation, a surgeon can find possible reason for asymmetry. Since you did not post your preoperative photos, it is possible that a small asymmetry was present before surgery but your surgeon did not address that issue with you. It would be in your best interest to see your surgeon and discuss your problem. Good luck.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph. Nothing replaces an in-person examination but it appears that the pocket of your left breast may be a bit too large along the outer side, allowing the implant to slide off the chest.  I would discuss with your surgeon as another surgery would be required to correct this.

Sergei Kalsow, MD · Answer

You have to look at your pre op photos, sometimes you will see some asymmetry there, even though you didnt notice it before because you were not looking close enough.  They look in the right place and the same size.  Perhaps one side is forming a capsular contracture, if it is becoming hard. I would talk to the surgeon who put them in.

Daniel Barrett, MD · Answer

Dear Intuitive530468,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

You may have heard the expression that "breasts are sisters not twins".  Almost everyone has asymmetry to their breasts.  Healing often is different for the right versus left when recovering from augmentation.  I encourage you to speak with your surgeon about your concerns.  Review your pre operative photos together as well as your final results.  Together you can determine if you want further intervention to address them.

Benjamin J. Cousins, MD · Answer

Thank you for your post, photos and questions. It is best for you to see your original plastic surgeon so that you and he/she can discuss your concerns and review options available to you. For the best and safest results be sure to see a Board Certified Plastic Surgeon who is experienced and will take time to visit, examine and review with your concerns. Hope this helps.

Benjamin J. Cousins MD
Board Certified Plastic Surgeon Miami/Miami Beach, FL

Benjamin J. Cousins MD 
Board Certified Plastic Surgeon Miami/Miami Beach, FL

Connie Hiers, MD, FACS · Answer

I'm sure your surgeon did an excellent job. Your implant has shifted a little to the side. This can happen with implants placed behind the muscle.  Since you do not use your two arms equally, the muscles will not push on the implants equally.  Discuss this with your surgeon if you want. Your pocket could be tightened.

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