6months post op and breasts are uneven - will this drop over time or should I consider a revision? (photos)

I would recommend a revision to try to address the symmastia, asymmetric nipple position, and high riding implants. I would wait a full year prior to attempting any type of revisionary surgery.

You will need a revision. The implants will need to be removed, the pockets need to be plicated medially and the lower pockets corrected for the asymmetry. I recommend a circumareola approach to excise excess skin to make the nipple-areola complex more symmetrical and positioned more medially.

Best Wishes,

Gary Horndeski, M.D.

It is unfortunate that you're in this situation. More information required for a proper answer. YES, the solution for you is surgical, but formulation of a plan that will create the beautiful breasts you want requires an understanding of decisions and ,techniques from your first procedure and your aesthetic preferences. Foundational to our approach is the understanding that women don't present for breast implants, they present for beautiful breasts. Our procedure and choices are designed for that outcome. True, we don't have 100% control, but for young women having primary augmentation, your result implores a new paradigm.

Your nipples started off being low and pointing laterally so they will still do this. However, the implant base can be adjusted so your breasts are further apart to help. You have one breast that sits higher than the other because one shoulder is higher than the other. However, you probably have a capsule holding the implant higher. You can try oral Accolate and eternal ultrasound treatments or go back for surgery to release the capsule. Please discuss your concerns with your surgeon.

Breast augmentation outcomes are based on three variables.
The first is the patient’s candidacy for the procedure in the first place. The second is the choice of implants in regards to size shape and type. The third variable is the surgeons ability to put the implants in the correct anatomic location.
In your case, your candidacy for breast documentation is somewhat limited.
This stems from your breast sitting fairly wide on your chest wall with significant breast divergence.
These characteristics are typically amplified with the projection of breast implants.
In your case, your surgeon put the implants , where the ideal breast position should be.
Unfortunately, that’s not where your breast sit.
Your breast sit wide on your chest wall and the surgeon can’t move where your breast sit on your chest wall.
In order to center the nipple over the implant the implant should’ve been placed laterally Where your breast sits.
Your surgeon probably didn’t want to have your implant that where your breast are.
Likewise, you have significant divergence and this is always going to be put on display with implants. Personally, I feel that the implant should be centered on the breast, even if it means placing the imprints far apart on women who have breast that sit far apart.
If your implants were placed centrally over each breast, then they would sit wide with no cleavage in your midline.
It’s a tricky situation there’s no easy way to end up with a good outcome, which should’ve been explained during your consultation. there’s no easy way to correct breast divergence.
This is simply a normal breast anatomy that some women have.
As I mentioned previously divergence is usually amplified with the projection of the implant.
Ideally, your candidacy for the procedure, including the position of your breast on your chest wall and the degree of divergence and the implication for breast augmentation should’ve been discussed before scheduling surgery.
Follow up with your provider and discuss your concerns with him or her.
You can always schedule a few in person second opinion consultations with other plastic surgeons in your community as well.
Placing the implants so that they are centered on your nipple may not look so great either.
Best,
Mats Hagstrom MD