Is it worth doing a revision for 35cc? My right breast is 360, left is 405. I feel the left needs to be smaller implant. (photo)

Hello,Your asymmetry has less to do with volume differences, and more to do with implant position differences. Your left implant is lower, which might have been the cause for filling such a large difference in volume based on the minimal discrepancy in initial breast size. Adding saline will not make a difference, and you will need a much more complex surgery to adjust implant pocket (s), after waiting at least another 2 to 3 months. If your doctor is not an ABPS certified/ASAPS member surgeon, you should visit a few who are expert in revision surgery.  You should also consider getting silicone gel implant as well. Best of luck!

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

You need to allow 8-12 months for the breasts to completely settle before making any decision regarding revision all surgery. The swelling definitely needs to resolve and 7 weeks is much to early to have an opinion regarding size differences.

Congratulations on
having undergone the breast augmentation procedure. I ask my patients to wait
3-6 months before evaluating the end results of the breast augmentation
surgery. This waiting time allows patients to adapt to the changes in their breast size
and shape as well as their overall new body image. There are a
significant percentage of patients at your stage of recovery that feel that
they are too big or (more commonly) too small. And those emotional feelings can
change daily turning this transitional time. Remember also that each
side of the body heals at a different rate and that you weren't perfectly
asymmetric to begin with so although you should be closer in symmetry there
will always be differences.
It can take many months to see the
final results of surgery. Swelling, soreness, skin repositioning, implant
settling must resolve completely before you can make that determination. Once
the swelling around the implants has also resolved you can see the final
result. Patients often report that they are happier with the implants' shape
their cleavage and projection once these changes occur.
I would suggest continued patience and
continued close follow-up with your plastic surgeon.
Best wishes or an outcome that you
will be pleased with long-term.

I am sorry to hear about your concerns after breast augmentation surgery. Best to continue to be patient and evaluate the result of the procedure performed several months from now;  hopefully, breast symmetry will improve as the breast implants fully settle. If ongoing asymmetry is of concern long term,  whether or not revisionary breast surgery will be "worth it" will depend mainly on how much the asymmetry concerns you. If your concern is minimal ( once in a rare while), then revisionary surgery is probably not worth the potential risks associated with additional surgery. If, on the other hand, the asymmetry concerns you on a daily basis, then the revisionary surgery will likely be worth the effort.   Keep in mind that revisionary breast surgery may not just be a matter breast implant volume but breast implant capsule adjustment as well. Best wishes.

Thank you for your question and photographed.  You are still very early in recovery and the implant has not adjusted to your body and breast.   I strongly recommend that she wait at least 3 months so you can have a better idea of how it looks before considering a change.  My guess is that it will look acceptable after implants have dropped and full left.