Asymmetrical breasts after revision. I don't like the way either breast looks. What are my options? (photos)

Question

I had my first breast augmentation with 450cc high profile implants in 2020. I needed a revision on the left side (appears on the right in the photos) for a double bubble and flex deformity. The L implant is now over the muscle , and the R implant is under. They look totally assymtreical to me and I’m really upset. What revision surgery can I do to make them look more symmetric? I don’t like the way either breast looks.

Gianfranco Frojo, MD · Answer

This is a complex problem to address. I would recommend placing both implants under the muscle, downsizing to a significantly smaller implant, placing soft tissue support/internal bra (Galaflex), and performing a breast lift. The placement of very large implants can create significant problems and change the breast shape. In addition, having implants in different pocket planes (below vs above the muscle) can create very different aesthetics. I would recommend seeing a board-certified or board-eligible plastic surgeon with actual training in plastic surgery and an aesthetic fellowship. I find it also very beneficial if the surgeon has 3D imaging that can help simulate your revisionary surgery prior to the actual case.  Best of luck!

Daniel Barrett, MD · Answer

Dear Giraffespots00,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeremy S. Nikfarjam, MD · Answer

Hi Giraffe,
I'm sorry to hear of your complications!You may want to discuss a mastopexy (breast lift) with your revision surgeon. You will also have to decide which plane to keep your implants on. I typically perform my breast augmentations under the muscle, and then reposition skin and tissue to match that placement.
Best of luck in your search for treatment!
-Dr. Nik

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to breast revision surgery.  In your case, I would replace the left breast implant under the muscle and performed Reductive Augmentation.  This would include an internal bra/capsulorrhaphy procedure to bring your implants much higher, performing a mastopexy-lift, and removing inferior pole breast tissue.  You are an excellent candidate for this.  Best wishes to you.

Shana Kalaria, MD · Answer

I would recommend implant exchange, capsule work on both sides and breast lift. You would get the best result with an anchor lift. Your surgery is complex. I would recommend seeing a board-certified plastic surgeon with experience in breast revision surgery. Good luck!

Connie Hiers, MD, FACS · Answer

The implant behind the muscle look more natural and is much better supported. I would suggest moving the other implant behind the muscle to achieve more symmetry. Don't go larger or you may have more concerns about sagging from increased weight.  I would consider going down in profile as well and even a little smaller. Smaller implant and lower profile will fit your frame and tissue better.

Asymmetrical breasts after revision. I don't like the way either breast looks. What are my options? (photos)

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