Right Silicone Implant is Smaller Than Left

Right Silicone Implant is Smaller Than Left.  Doctor Refused to Go Bigger on Right. Looks  awful. At my pre-op appointment, I told him that right side was considerably smaller than my left and he just said that he would put the same size in both sides. I am very disappointed. I am 2 months post-op and sure enough left looks much bigger than the right side. What can I do? I see him today and I am so angry. I e-mailed him but he never responded. Please help!!! Thank you.

Doctor Answers 8

Correcting breast asymmetry with silicone implants.

I'm sorry to hear that you disappointed with your result.  Most surgeons will have a revision or exchange policy and this maybe something to look for in your paperwork.

This is certainly something you can discuss with your surgeon and hopefully come up with a mutually agreeable resolution.

You're also relatively early in the healing process and there still may be some changes.  For example, it may take longer for the implant in the breast that was smaller to see full projection.  If the skin envelope of the breast was smaller to begin with it will take longer to stretch.

Your surgeon may have had reasons that he simply has to clarify with you about the choice of implants.  Sometimes a larger size will tip you in the other direction making the smaller breast wider and bigger.

Open and nonconfrontational communication will likely be your best solution.

Best wishes.

Washington DC Plastic Surgeon
5.0 out of 5 stars 104 reviews

Breast Asymmetry after Breast Augmentation?

Thank you for the question. 

I would suggest calm, not accusatory communication with your plastic surgeon expressing your concerns. I'm sure your plastic surgeon will do everything he he/she can do to improve the symmetry of the breasts ( if it is possible to do so).  Sometimes breast asymmetry cannot be improved with further surgery and should not be undertaken.

If you feel that there is a “failure to communicate” after you meet with your surgeon a 2nd opinion may be helpful.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Breast asymmetry and augmentation

I am sorry to hear that you are unhappy with your breast augmentation. An important point to discuss in the initial consultation are any chest wall/breast asymmetries that exist. It sounds like you and your surgeon were aware of this before surgery. Often, the asymmetry can be improved, but not completely eliminated after augmentation. With the use of silicone implants, the size ranges are more limited due to the fact that silicone implants do not come in every size. With saline implants, there is more flexibility in filling to a broader range of sizes. In addition, there is also the possibility of using breast sizers in the operating room to get an idea of how symmetric the two breast will be after final implant insertion.

Good luck

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Breast asymmetry after gel implants

Breast asymmetry is a very common problem and I tell patients that no one is perfectly symmetric before or after breast surgery.  Gel implants are a set volume and in some cases there is no size of implant that is going to exactly correct the size issue.  Saline implants can be adjusted at the time of surgery so volume match is often obtainable.  Also, no implant corrects issues with nipple asymmetry or chest wall asymmetry.

I would be very calm and clear with your doctor.  I am sure he was doing what he thought would give you the result you were looking for.  Believe me, no doctor wants an unhappy patient.  It may be that revision will get you closer to the result you want but please remember, we plastic surgeons at least try to make them perfectly symmetrical whereas God doesn't bother to try. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Asymmetric implants

If you are unhappy with the asymmetry of your implants, you should talk to your surgeon. Remember that no two breasts are exactly the same and that mathcing them up exactly is almost impossible. Each breast will have a different base diameter and shape from the get go.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews


this is always a tough issue.  what you feel is considerable asymmetry might not be correctable given the measurements of implants.  your surgeon may have been worried that the other breast would be bigger if he moved up a size on the smaller side.. at 2 months not all swelling is down.  give it a good six months.  stay calm.

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 64 reviews

Probably different size implants should be used

It sounds like you have asymmetry of your breasts, including size.  That is a common problem and usually easily corrected with different size implants to each breast, the larger implant going into the smaller breast.  Sometimes, you may need a lift on one side if one side is drooping more than the other.  But often size and shape discrepancies can be corrected.  It is not necessary to put the same size implants into both breasts.

James Tang, MD
Houston Plastic Surgeon
3.4 out of 5 stars 18 reviews

Breast Implants - Right Silicone Implant is Smaller Than Left

Hi lopsided

Time to stay cool and have a straight-forward discussion with your PS.

It's hard to make any sort of realistic assessment without seeing a photo and, in general, this discussion is something you can only really have with the surgeon who saw you before your surgery, and who knows what you had done.

But here's the issue now:  what can reasonably be done to make you more symmetric?  Maybe there was a very good reason why the surgeon felt he couldn't go larger at the time of the surgery?  Was the skin tight, what were your proportions, etc.  Maybe putting in different size implants would have been difficult for some other reason?

While I understand that you're upset and angry, you'll be more likely to achieve the result you want if you can have a reasoned discussion with your PS.  Explain again what you wanted, go over what has not been achieved, and see what the options are.  It may be feasible at this point to go back and redo the smaller side...it also may not be.  And if that's an option, you'll have to go over some of the costs.

I realize that this is not a pleasant discussion - but you need to have it for your own peace of mind and satisfaction.  In the greater scheme this is not, of course, an insurmountable issue....but that doesn't in any way lessen its importance to you at this stage.  At least it sounds like it can be addressed!

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.