Can I just get straightforward implants with small asymmetrical breasts? (Photo)

Yes — you can have a natural-looking result with implants alone, and in your situation the best way to do that is with a Preservé (tissue-preserving) augmentation approach.A Preservé augmentation focuses on:Preserving your natural breast tissue, ligaments, and footprintAvoiding unnecessary skin or nipple surgeryCorrecting asymmetry through precise pocket control, not lifting scarsWhy Preservé works well for small, asymmetrical breastsIf your breasts are small, not sagging, and nipples are reasonably positioned:You do not automatically need a liftYou do not need nipple reconstructionAsymmetry can usually be corrected with:Careful implant selection (sometimes different sizes/profiles per side)Controlled, conservative pocket dissectionRespecting each breast’s native anatomy rather than forcing symmetryThis approach keeps the breasts:SoftNaturalProportionateAnd avoids the “operated” lookWhen extra procedures are not neededWith a Preservé philosophy:Lifts are added only if there is true sagging, not because breasts are smallNipple surgery is avoided unless there is a real positional abnormalityScars are minimized by design, not compromise

Thank you for your inquiry! We would love to meet with you to discuss your concerns. With asymmetry, you may need different size implants. Based on the photo, you should not need a surgical lift. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals!

Straightforward implants should provide a nice result. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dear Pioneering633192,

determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

All breasts are asymmetrical right to left before and after any surgery. This also includes size, shape, folds, chest wall, etc.

If you are ok with small asymmetry, you can augment both straightforward for natural results.

You can add a lift for the larger side but only if wanted.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Your asymmetry is in both breast glandular volume and skin surface area, but not nipple position. Implants will nicely augment both sides but my approach would be a carefully planned and masterfully executed peri-areola skin reduction on the side with more skin. Radial scoring for expansion of your inframammary crease and implant profile differentiation recommended. Yours is a case for an expert plastic surgeon only, much more complex than “straightforward.“ We have a few results posted in our asymmetry gallery showing management of such issues.

Thanks for your questions and photo. Based on your photo you appear to be an excellent candidate for breast augmentation with asymmetric implants. Breast asymmetry in women is more the rule than the exception. Find a board certified plastic surgeon with whom you feel comfortable and confident based on his or her gallery, reviews, and office staff. More than one opinion may be necessary for you to feel good about moving forward. Best of luck to you.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos alone, you appear to be a reasonable augmentation candidate. Your nipple position is preferred. You don't need any additional interventions (as far as I can appreciate from photos alone).
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.