Should I get 2 different sized silicone implants or the same size?

Question

My natural breasts are different sizes. One is slighter smaller then the other, I want to get silicone implants under the muscle. I want them to be the same size!

Jed H. Horowitz, MD, FACS · Answer

Using Different Size Breast Implants For AugmentationIf there are small differences in size,  I may choose to use the same implant.  As the volume approaches 1/2 to one full cup size,  two different implants should probably be used.

Gary M. Horndeski, MD · Answer

Breasts
frequently are different sizes, shapes and position.  Unfortunately, you have not provided any
photographs but there may be other asymmetries. 
If your breasts are asymmetrical I recommend a new technique called
Breast Augmentation with Mini Ultimate Breast LiftTM.  Using a circumareola incision it is possible
to reshape your breast tissue creating upper pole fullness, elevate them higher
on the chest wall and more medial to increase your cleavage.  Through the same incision, implants can be
placed.  Aligning the areola, breast
tissue and implant over the bony prominence of the chest wall maximizes
anterior projection with a minimal size implant.  Small round textured silicone gel implants
placed retro-pectoral look and feel more natural, are more stable, less likely
to ripple or have complications needing revision.  Implant profile is irrelevant in the
retro-pectoral position since the muscle compresses it.  This technique can correct asymmetrical size,
shape and position. Best Wishes,Gary Horndeski, M.D.

Joe Gryskiewicz, MD, FACS · Answer

Thank you for your question.  It is very common for women to have differences between breasts.  Without pictures, it is hard to correctly answer your question.   Having a consultation with a board certified plastic surgeon will help you determine if two different size implants are needed to help you achieve your goal.  Best of luck!

Mark E. Mason, MD · Answer

You said that your natural breasts are different sizes. In order to achieve a more symmetrical look, it makes sense to use implants that are sized appropriately to give you the result you want. This is not uncommon in patients; most patients have one breast that is slightly smaller than the other. I would make sure to try on different implant sizes during your preoperative appointment (or whenever the sizing is done) so that you get a clearer picture of what the final result may look like. Good luck with your surgery!

Michael Burgdorf, MD, MPH · Answer

Most women have slightly asymmetric breasts. In choosing implants, it is important to note that in the pre-op setting. If the asymmetry is only slight, like 25-50cc, it might not make a noticeable difference with different sized implants. That small volume difference is like a swallow of water. It should be noted, thought, the small asymmetry will still be there after the surgery, and can potentially be a little more noticeable. If, however, larger asymmetries exist, there is a greater need for different sized implants to balance this out. Good luck.

Charles Cope, MD · Answer

Hi. It is hard to comment without a photo, as the answer depends on how different your breasts are. 7 out of 8 women's breasts are slightly different in terms of size/shape/crease under the breast - this is essentially normal. If your breasts are very different in size then you will make them more equal in volume with different size implants, but the shape is often still slightly different - they are usually not exactly equal. Try to find someone with a Vectra 3D imaging machine in your area to
simulate your breast augmenation result - in a recent article (Oct 2013) of
Plastic & Reconstructive Surgery Journal (Plast. Reconstr. Surg.132:
810, 2013.), the main Plastic Surgery Journal worldwide, the 3D imaging VECTRA
machine was found to be beneficial for patients considering breast augmentation
surgery.
The article concluded that patients prefer a center that offers
three-dimensional imaging technology; they feel that the simulation is very
accurate and helps them greatly in choosing the implant; and that if they could
go back in time, they would choose the same implant again. All the best with
your decision. Regards Dr Charles Cope

Justin West, MD · Answer

Nobody has perfectly symmetric breasts, before or after surgery. For patients whose breasts are nearly equal in size I generally put in the same size implants. For patients who have a bit more of a discrepancy I will use different size or style implants to get the best match. One thing to consider is to try to find a plastic surgeon who has a Vectra 3-D breast imaging system. This high tech camera takes a 3D photo of you and lets you see what you will look like with every implant on the market. You can try a 300cc on one side and a 350 on the other. Keep trying different combos until you figure out what looks best on you. Only a small percentage of us have this technology so you may need to call around until you find someone who has it. Good luck.

Curtis Wong, MD · Answer

If you're close to even, stay with the same size.  An easy analogy is to visualize a ping pong ball and golf ball side by side... the golf ball is bigger.  Now add a baseball to each and mix well and round it up and now it much harder to tell the difference.  If you are a half cup different, it certainly is worth it

Jaime Campos Leon, MD · Answer

Thank you for the question.To best help you, a physical examination would be required in order to determine which sizes would be best for your case.Dr. Campos

Steven M. Camp, MD · Answer

Hi,Thanks for your question.  It is actually fairly common to have some asymmetry between breasts and that could be due to a number of factors.  It may be that your chest wall is asymmetric, or it could be that the breasts are actually different in volume.  Either way, I recommend a thorough consult with an established plastic surgeon to help you make the best decision.  After consultation you should have a better understanding of the type of asymmetry in your breast, and how to correct it.

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