Do I Really Need Corrective Surgery for Uneven Breasts?

I had saline breast augmentation 4 months ago (under muscle). I thought one breast was larger than the other was a minor difference. I went for my follow up and my PS's, PA thinks that one has settled differently than the other and that my cleavage line is uneven. Both breast are soft and if symmetric, would be perfect.

They have suggested massaging the one that is sitting a little bit higher and want to see me again in two weeks to see if anything has changed. They mentioned corrective surgery for capsular contracture. Should I have a second opinion?

Doctor Answers 9

Take your time with this decision

First of all, if the difference is that slight, it will probably settle with time over the next couple of months. Massage can help, but most importantly, don't be convinced by anyone that you "need" a revision. If you're happy with your results, that is what matters most.

You can always have a revision procedure down the road, but for now, I would recommend being patient and giving yourself at least 6-9 months after your procedure before deciding on more surgery.

Good luck,

Dr. Salemy

Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Breast asymmetry

Soemtimes breasts settle out differently from side to side.  In my opinion the two breasts are never exactly the same as they were not before surgery. If it bothers you or one has not fully come  down, then perhaps you need it corrected.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Give it more time


Thank you for your question.

I would not rush into surgery right away. It is still early. Your breasts could even out. However, it is not uncommon to still have some asymmetry once some time has passed. Corrective surgery for capsular contracture is an option, but not your only option. I would do the massages over the next few weeks as recommended and go from there.

Most importantly, its always up to you. If you are happy with the little difference in size then surgery might not be the best option. Never do anything you do not feel comfortable with. Always wait at least 6 months after your original surgery to see how asymmetries settle out.

We believe that each patient needs to be treated as an individual, and we focus on listening. Obviously, I would need to examine you and help you to decide which surgical or non-surgical options are available in your particular case.

Thanks for your question. Have a great day!

Best regards,

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 1 review

Not Right Now

It takes many months for the "final" result to become apparent. Things will continue to evolve. After your surgeon states that "this is how it is going to look", then make a decision. If you are pleased with the result, do not have another procedure. If you are not ,make sure your surgeon can improve upon what you are not pleased with.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 19 reviews

Just be patient

Differential healing is common and you will still see settling over the next 6 months. Massage as instructed and ask to look at your preop pictures. Often the subtle preop asymmetries the patient wasn't aware of are magnified in the augmented state and become suddenly noticed. Either way, stick close to your doctor, not the PA, and try to be patient a bit longer.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

It is still early.

It is still relatively early as the implants will continue to settle. Massaging may help them over time.

The bottom line of symmetry is completely up to you. If you are satisfied with the result, no further surgeries are needed. If you are not satisfied, massage and wait a few more months and re-evaluate with your Plastic Surgeon. Most womens' breast have some degree of asymmetry, but a significant differeence can be corrected.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Minor breast asymmetries are common

If your breasts are soft it is very unlikely that you have a capsule contracture, and if you are pleased with your result there isn't anything to do.

Almost all individuals have subtle asymmetry in the breast. This may be related to a small volume difference, a subtle difference in the nipple size or position, or a difference in the skin or fold of the breast. Ideally augmentation should soften these differences and make the breast more symmetric. Often when there are differences between the breasts it is possible to go back to the "before" pictures and the subtle differences may be noticable as you look at them carefully.

It is safe to massage the breast, both if you wish, and over time the breast may settle to better accomodate the implant. A year would not be too long to wait, and again if you are pleased with your results, you should be the judge.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Sounds like good advice for uneven breasts

It sounds like your plastic surgeon has given you good advice at 4 months post-op. Massage is extremely helpful. There are reports that ultrasound and oral Accolate help soften early scar contractures. If after 6 - 12 months you are happy then there is no indication for surgery. Otherwise, you should discuss with your plastic surgeon to see if some revision is indicated.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon
4.1 out of 5 stars 8 reviews

If you are pleased, let them know

hol70: You sound like you are basically pleased with your augmentation result, and that the differences are minor. I suspect your surgeon wants you to have the best outcome possible, but you and he realize that surgery is imperfect. So, discuss your opinions with your surgeon at your next visit.

If he or she suggests corrective surgery that you do not think you need, a second opinion would be worthwhile.

Sutton Graham II, MD
Greenville Plastic Surgeon
4.8 out of 5 stars 5 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.