Correct breast asymmetry & high creases through implants alone? I don't want my 34B/C breasts to be any larger than 34D. (photo)

Question

I've had 2 consultations for breast asymmetry & high creases. 1st dr would use implants to would fill out the lower part of the breast, lifting my nipple. The 2nd recommended a reduction on one breast and a lift on both w/ implants, requiring many more incisions. I worry about the scarring but I also want my nipples to lift a bit using small implants. Questions: 1) can a small implant achieve a lift of the nipples 2) how difficult is it to obtain symmetry through implants alone?

Nana N. Mizuguchi, MD, FACS · Answer

To answer your questions, a small implant alone cannot lift the nipples.  Symmetry cannot be obtained with implants alone. You have tubular breasts, constricted medial folds, large areola and volume asymmetry.  I recommend silicone implants and a full mastopexy on the right and, to a lesser degree, a mastopexy on the left.  Keep in mind, you have a higher risk of revisional surgery because of the amount of asymmetry.  Revisional surgery is minor and many times under local anesthesia.  You can have beautiful breasts.  I recommend a Board Certified Plastic Surgeon with experience in this type of breast surgery perform the case.  Please call my office with any questions.Thank you.

Marwan R. Khalifeh, MD · Answer

I would agree with Dr Bermudez response below and explore your options with the second surgeon you will have a much better result and symmetry this way.

Kenneth Bermudez, MD, FACS · Answer

Any implant, whether big or small, will only achieve a minimal lift, if any. This shouldn't be the primary method used to lift the nipple. In patients with nipple ptosis, the only real option is to perform a lift, either with breast reduction or mastopexy (breast lift).It is impossible to attain perfect symmetry in a patient with significant asymmetry as pictured above. Improved symmetry is a more reasonable expectation. I don't think implants alone will achieve the optimal symmetry.Most patients with significant nipple ptosis, breast asymmetry will need a combination of lift and implants to achieve the best possible result.Most importantly is to make sure you are seeking the advice of a board certified, ABMS, plastic surgeon.Good luck.

Robert Whitfield, MD · Answer

You differences in breast size and shape will only be enhanced with implants.  That is why you will get varying opinions about how to deal with the asymmetry.In breast augmentation I have chosen to spend time reviewing
photographs with patients to fully understand their expectation of size and
shape.  Many times this simply raises
more questions.  I will make measurements
and use the implant guides to allow the patient to understand exactly the sizes
that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide.  These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!

Carmen Kavali, MD · Answer

Thank you for your question and helpful photo.  I think it is not possible to correct your asymmetry without doing a lift along with the implants.  If you just have implants now, I can almost promise you that you would not be happy with the results, especially on the left side.  You need a lift to get better symmetry.  Some scars are worth it, even though we wish we could do without them.

Lee E. Corbett, MD · Answer

In my opinion, it would be impossible to correct your droop with implants alone or get symmetry with implants alone. I think your best option is to have different sized implants placed, a lift on your right breast and a small reduction on your left side. Realize that no matter what is done you will not have perfect symmetry, your breasts are too different to begin with.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.Given the position and asymmetry of your breasts, I think you will do best with bilateral breast augmentation as well as breast lifting surgery. Breast augmentation alone will not achieve an aesthetically pleasing outcome. Select your plastic surgeon carefully and communicate your goals carefully as well. Goal pictures and the use of computer imaging may be helpful during this communication process. You may also find the attached link, dedicated to breast asymmetry concerns, helpful to you. Best wishes.

Jaime Campos Leon, MD · Answer

Thank you for the picture.I believe that you'll benefit by having a breast lift surgery and implants. The asymmetry issue will be corrected.Dr. Campos

Jeremy Pyle, MD · Answer

Asymmetric breasts are exceptionally challenging.  Part of the challenge is surgical and part is an open, honest conversation about expectations and how much improvement can be obtained.  Though the volume may be able to be made similar with just an augmentation, the appearance of the breasts cannot.  An implant will, simply, not provide two similarly shaped breasts.  I agree with the second plan.Best,Dr. Pyle

Matthew H. Steele, MD · Answer

Thank you for your question and photos.  Unfortunately, I think it would be impossible for you to achieve any symmetry with implants alone.  As others have pointed out below, a mastopexy (breast lift) or small reduction will be necessary in your case to improve the nipple position.  An implant can give a very minor lift, but not to the extent that you would need to get optimal aesthetic results.  Many of my patients are scared and worried about the breast lift scars.  Think of it like this:  "You are trading scars for improved contour."  The same ideas applies to a tummy tuck, where you get a better waist contour with the trade off of a scar.  Generally these scars fade well with time but are necessary to optimally shape your breast.  Make sure you spend time asking the appropriate questions and ask your board certified plastic surgeon for photos of patients in a similar situation. Good luck!

Correct breast asymmetry & high creases through implants alone? I don't want my 34B/C breasts to be any larger than 34D. (photo)

Answers (14)

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