Will 385cc in my right breast and 415cc in my left breast make one bigger than the other? Or will they be pretty even?

Question

My surgeon pointed out that my left breast is slightly smaller than my right. He recommended going with 385cc in my right and 415cc on the left. This is a 30cc difference and it seems kind of a big gap. I'm wondering if I should do 415cc in both I trust my surgeon but when I tried the sizers on I noticed a difference in size. I'm just not sure what to do! I'm fine with my breasts not being PERFECTLY the same size but I would like them pretty close. I would love to hear others opinions. thanks :)

Dallas Buchanan, MD · Answer

Thank you for your questions and pictures. This is a very common question that we get in consultations. I would say to correct the asymmetry if it bothers you. If you think things are significantly uneven, then choosing a slightly smaller/larger implant to correct that is a reasonable thing to do and if you trust your surgeon and he is suggesting it, then go for it. On the other hand, if you are ok with your current symmetry and worried about somehow "overshooting" the correction, then just go with the same size of implants and accept that the asymmetry will continue to a certain extent but will be natural. In the end, no matter which way you go, you will probably be happy as a volume difference this small will not make a significant difference or be noticeable in most situations. Hope this helps!

Keith Hodge, MD · Answer

Based on the photos, you have at least a 30 cc difference in volume. I would suggest that you follow your surgeon's recommendations. It will give you better symmetry, which is what we try to achieve for all of our patients. It is not uncommon to have asymmetry, and not uncommon to use different size implants. Good luck!

Sean T. Lille, MD · Answer

Everyone presents with differences in their canvas and when you increase the volume; those differences will become a little bit more noticeable. Despite this, picking different volumes can help. I use sizers in the OR to determine the best match because the appearance will look a little different once the implants are under the skin and muscle. you will do great!

Urmen Desai, MD, MPH, FACS · Answer

Trust in your surgeon.  Breasts are sisters, not twins.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and photos. 30cc may sound like a lot but it is essentially 2 tablespoons. This volume, spread out over a whole breast can be quite subtle. Balancing asymmetry with different sizes can be very effective. My patients find it helpful to try on the implant sizers with a form-fitting t-shirt in order to get an idea of how they will look. Sometimes adjusting an asymmetry can feel strange and difficult for the patient to adjust to- even though they appear to be a good match. I recommend that you talk it over again with your Plastic Surgeon and see if using rice sizers at home could be a helpful way to get used to the balance.All the best

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.   30cc implant size difference will not be too noticeable.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique. 
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thomas S. Taylor, FACS · Answer

It is common to have small breast asymmetries like yourself. With silicone implants this asymmetry can be corrected somewhat by using different-sized implants. As you mentioned the silicone implants come in different sizes, in increments, so many times we can improve the symmetry but we can't get it perfect. That is a restriction of silicone implants.  I use intra-operative silicone sizers to see what combination of implants gets you the look you are desiring with the best symmetry. From your photos it does appear you will need a larger implant for your left breast but I would reserve that opinion until you were sat upright in the OR with the sizers in place and a visual confirmation of symmetry was made. I hope you find this information helpful.Thomas Taylor, MD, FACS

Himansu Shah, MD · Answer

Thank you for the question and photos. It is difficult to answer your question without examining you, however, from reviewing your photos you do have asymmetry. It is best to try different size implants like you have done and if look symmetrical than it is appropriate. If you are still not convinced than another option is to try sizers intraop and trust your board certified plastic surgeon to make the right decision. Good luck.

Daniel Barrett, MD · Answer

Hi missmk95,

Determining the idea breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient.

We have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.

Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.

Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.

You should visit a board certified plastic surgeon for an in-person examination and advice. Also, make sure your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  I do think that there is a minor asymmetry in your breast size that can be improved upon with a subtle difference in breast implant sizes.  This can most reliably be done at the time of your surgery through the use of gel sizers by your surgeon.  Remember that the differences in volume between your breasts will appear smaller as the overall size of both breasts increases.  Hope this helps.

Will 385cc in my right breast and 415cc in my left breast make one bigger than the other? Or will they be pretty even?

Answers (20)

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