Lopsided breast and seeking help (Photo)

I am a female in my early twenties and have always been uncomfortable with my breast. I have two problems 1) they are two different sizes I would say at least a cup size difference. 2) they are very low and saggy for my age. I feel like this is my time to feel good and confident and my breast are holding me back. I wear a 34c and would love a fuller closer together appearance. Any suggestions are greatly appreciated. I'm curious about size of implants and whether or not a lift is needed.

Doctor Answers 13

Lopsided breast and seeking help

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Hello dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue, hugs!

Dominican Republic Plastic Surgeon
4.5 out of 5 stars 442 reviews

Seeking help

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Thank you for your photos. You do not appear to need any lift. Many women have different volumes in their breasts. Implants with different volumes can correct this. Be sure to consult with Board Certified Plastic Surgeons who can help you achieve the look you desire. Best Wishes

James A. Hoffman, MD
Saint Paul Plastic Surgeon
4.8 out of 5 stars 68 reviews

Breast lift?

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Thank you for your question and photos.  It does not appear that you need a breast lift but rather two different sized implants to correct for the asymmetry of your breasts.  During a consultation with a board certified plastic surgeon in person, he or she will be able to help you choose the implant size and profile that is best for you given your surgical goals.

All the best,

Dr. Results
Miami, FL

Breast augmentation

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Thank you for your question and photos.

From the photos, it looks like you may not need a lift. I think you would benefit from different size breast implants. This should significantly improve the symmetry of your breasts.

In our practice, we spend a significant amount of time to help our patients choose the perfect implant. We use silicone sizers as well as 3D imaging to give a preview of postoperative expectations.

Be sure to consult with a board certified/eligible plastic surgeon.

Best of luck.

- Dr. Bryson Richards (Las Vegas Plastic Surgeon)

Breast surgery

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Hello, a symmetrization procedure is the one of choice in your case, silicone implants can be used, a lollipop incision will be needed to perform this surgery . Regards 

Kemil Issa, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 15 reviews

Lopsided breast and seeking help

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You should be able to obtain a good result with breast augmentation by using different size implants. Perfect symmetry does not exist in nature but improvement should be straight forward.  Be sure to consult with a board certified plastic surgeon with an expertise in cosmetic breast surgery in your area. Good luck! Dean Vistnes. 

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 51 reviews

Breast implants will help

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You should see a plastic surgeon.  Implant sizes can only be determined after careful consideration of many factors.  This is not a question that can be answered on a whim.  Serious two way discussion between surgeon and the patient is required for such decisions.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews


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You will probably require both implants of different volume and a lift to tighten the looser Breast surgeons can determine best approach for you

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 43 reviews

Implants or lift, its up to you

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You could either have an implant alone, or a breast lift alone.  It would depend on your goals, how precisely you want the asymmetry fixed, and the experience of your surgeon.  Combining the lift and implants in one operation is something I would not do.  A lift with an implant is controversial for two reasons. First, when you perform a lift you are making everything tight and closing the wounds under tension. It you add the expansive forces of the implant at the same time, you are fighting against yourself. There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars. In the worst case, the wounds will open. So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant. Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure. Or a smaller implant than would be appropriate is used so as to decrease the expansive forces. Either way, you are compromising the aesthetic outcome. Often the outcome is so compromised that a second revision surgery is required. If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation. The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved.

The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple). By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple. By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple. If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop. If the venous outflow stops, the arterial inflow is stopped. If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies.

Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation. Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.


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Consult with a board certified plastic surgeon for an in person evaluation.  Your photos do not show enough for a recommendation.  Try on sizers in your surgeon's office to get a clear understanding of the volume being added.  Best to you!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 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.