Correct or not correct asymmetry during augmentation? (photo)

Question

I am having surgery in the next month but cannot decide if I should correct or not. Correct the asymmetry I have. If I don't correct, I would be going for 244cc motiva mini which my surgeon has recommended. However, I do have quite an asymmetry that ideally I would like to fix. Should I suggest two different sizes? My surgeon mentioned that with the new implants, my asymmetry would look a lot less with the implants. Is this correct or will the asymmetry still be noticeable?

Joel Patrick Maier, MD · Answer

I would bet that using the next size up implant for the right side can help your asymmetry. It is impossible to make them the same as the foot print of your left breast and chest wall is larger. I find that chasing asymmetries more than two implant sizes can make things worse as you are placing a larger implant into a tighter pocket. I hope this helps. Thank you.

Ali Riza Öreroglu, MD · Answer

To get the most accurate result, a physical examination is necessary. You seem to have different volume between the two breasts. However, generally speaking, if the asymmetry is not very noticeable, new implants can typically reduce the difference significantly and provide a more balanced appearance. Additionally, if the asymmetry is more noticeable, using two different implant sizes could be a good option to achieve better symmetry.

If the asymmetry is mild, fat grafting could also be a solution. Fat grafting can offer a more natural correction, especially for filling volume differences. However, if the asymmetry is more severe, it may require additional surgical procedures beyond implants, such as a breast reduction or reshaping surgery.

Ultimately, to determine the best solution for your case, a detailed consultation and examination are necessary. This will allow us to decide which methods are best suited to achieving the desired outcome.

Jeffrey M. Darrow, MD · Answer

There should be no reason why you should be concerned about trying to correct your asymmetry. Whatever implant size you have chosen for your larger breast, can be placed first at the time of your surgery. Then an implant sizer can be placed in your smaller breast and inflated until the symmetry is as close as possible. Then your surgeon can place a slightly larger implant in on your right side to give you the best symmetry possible.  This procedure only takes a few extra minutes at the time of surgery but is well worth the peace of mind for you, knowing that you are as symmetrical as possible. Best wishes.

Leila Kasrai, MD, FRCSC · Answer

Please discuss your concerns with your surgeon. Because they’re more familiar with your situation, they’ll be able to recommend an appropriate solution. Size asymmetry can be resolved with different sized implants, and shape asymmetry may be slightly improved as well. However, your surgeon would be able to let you know by how much it would be improved so that you can determine whether your goals would be achieved.

Ira H. Rex III, MD · Answer

I think it is good to always consider different size implants when dealing with volume asymmetry.  Your plastic surgeon, with a precise examination, can usually make a good decision whether different size implants are used.  Often the decision is made during surgery with sizers.

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. Generally speaking, any pre-existing asymmetry tends to become more obvious following surgery unless it is accounted for during the procedure. A differential augmentation (placing different breast implant sizes in each breast) may help to improve the asymmetry in your case. Consult an appropriately qualified expert in aesthetic breast surgery. The use of 3D simulation software may be particularly beneficial in your case.

Brian K. Reedy, MD · Answer

Hello, thank you for your photo and question.  It is hard to determine if I would recommend two different size implants from just one photo and a non in person consult.  I think if you express your concerns with your surgeon he could be readily prepared during surgery where this sometimes needs to be when he makes that judgement call. We use a sizer implant first then sit you up during surgery to see how it would look. So, if he would need more on one side then the other to make them as close as needed, he could do so with the final implants. Keep in mind we all have a difference, but I completely understand wanting to get them to match as much as possible. Best of luck.

Daniel Barrett, MD · Answer

Dear gt123vh,

based on your photos, it looks like your asymmetry is not that severe so you might benefit from different size implants. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

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

Ted Eisenberg, DO, FACOS, FAACS · Answer

Your surgeon has the advantage of an in person evaluation and most likely the experience to advise you. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Jonathan Heistein, MD · Answer

Hi.  It is very difficult to say (with only 1 photo) if it would be better for you to have the same size implants, or to have a slightly larger implant in the smaller breast.  I would put in whichever combination gives you the least amount of postop asymmetry, and sometimes that is a decision made in the operating room while you are asleep.  Talk to your surgeon to discuss both options and the expectations with each since he/she will have a much better idea of what the outcome will be in each scenario.  Best of luck!