What is causing this asymmetry? (Photo)

Dear Helpful860429,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The capsulectomy was inadequate. Your breast is descending and the scar is rising. You would benefit from smaller implants and may need a circumareola approach to equalize the position of the nipple-areola complexes. You will also need inferior and lateral plication with permanent sutures.

Best Wishes,

Gary Horndeski, M.D.

Just based on your photos, I suspect you may have a capsule keeping one implant a little high. Please go back to your surgeon and discuss your concerns.

To make an assessment regarding the outcome of any plastic surgery procedure, we generally need to see a complete set of proper before and after pictures.
If you’ve had more than one procedure that we need to see before and after pictures of each of your previous procedures.
Understanding the indication for your revision surgery would also be helpful.
I don’t see anything obviously wrong with the outcome of your procedure.
Most people have the left breast sitting higher on the chest wall than the right side.
Either follow up with your plastic surgeon or schedule proper in person second opinion consultations with other plastic surgeons in your community.
For second opinion consultations come prepared to bring with you are complete set of proper before and after pictures and copies of your previous previous reports.
If you are original provider is still around then get copies of the medical record from your first operation.
Quality assessments require quality information.
Best,
Mats Hagstrom MD