Uneven breasts 18 months post-op, does the left pocket need to be enlarged?

Question

I had a breast augmentation 18 months ago. They were drastically uneven at 3 months post op. I was told they should even out over time and to wear a compression band to help push the higher one down. I did. They’re still not close to even. It’s noticeable when wearing a tight shirt. The surgeon said there is no contracture. Is this a satisfactory result? It seems the left implant doesn't have as much room to move around. Is it possible the pocket on the left side needs to be enlarged?

Ronald J. Edelson, MD · Answer

You have a small amount of asymmetry. Some patients would be okay with it and some would not.  I think it’s reasonable to drop the high implant half an inch since it’s such a minor procedure that would take less than an hour

Daniel Barrett, MD · Answer

Dear SamNYC82,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

Ryan Rebowe, MD · Answer

I would say that your result is certainly acceptable. While there is some slight asymmetry, it is important to note that no two natural breasts are exactly the same. The degree of asymmetry is noted in natural breasts with relative frequency. That being said, a left inferior capsulotomy will likely help with the asymmetry that you are talking about. At that time, it may help to increase the size of the implant or the implant size may be kept the same depending on how the implant fits in the new pocket.

Wess Cohen, MD · Answer

Thank you for your question. You are right that your breasts are uneven with your right breast lower than your left. This was apparent in your preoperative pictures as well as your right breast fold is slightly lower than your left. In performing the breast augmentation, this is put under a magnifying glass and appears to be worsened. While lowering, the left breast is an option, the better and safer option is to actually raise the right breast. This can be done by raising the breast fold and can be further supported with an internal mesh bra. Good luck.

Camille Cash, MD · Answer

There is some mild asymmetry noted in your photos but the result appears acceptable.  You can consider a revision to improve it, but it is important to understand the risks versus benefits of doing so.

Connie Hiers, MD, FACS · Answer

You are not even in your before photo, but your shoulder is even higher on the side that the implant is higher in your after photo. If your implants move equally well, then the problem may be your bone structure which cannot be changed. If the pocket is tighter, then it can be opened. You might have some success with external ultrasound and oral Accolate.  In your before photo, one breast and nipple do sit lower, and you continue to do that now.

Shana Kalaria, MD · Answer

It is possible to enlarge the left side pocket to the let the implant drop a little further. That being said, you have a good result, but it can be improved. Please visit with a board-certified plastic surgeon as revision breast surgery can be complex. Good luck!

Douglas Taranow, DO, FACOS · Answer

In photos, your breasts look very even.  I’m surprised that the left one dropped down into the pocket and is now symmetrical.  
They are always sisters not twins.  Unless there is something I cannot see without an exam, I would say leave them alone.

Uneven breasts 18 months post-op, does the left pocket need to be enlarged?

Answers (8)

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