Breasts Are Still Asymmetrical After Augment and Revision- What to Do?

I got breast augmentation 600cc. I am 6 feet 180lbs. Left breast did not descend nicely and looked too high and small. Doc did revision by going up to 650 in left breast and lowering incision on bottom. Now it's been 5 months and left breast appears bigger than right, nipple is higher, and breast doesn't move up when I lift my left arm. I don't know if I should get the right one bigger which might fix alignment of nipples or get left back to 600 and don't know if it was cut too low?

Update: Photo added

Doctor Answers 10

Still Assymetric After Augmentation and Revision. What to Do?

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There are a number things which do not seem to add up in your situation. Also your photo is taken from a low perspective, so it is difficult to see what your breasts truly look like. 

Given all that, I think there still a number of things worth discussing. First, nipple position is almost never exactly symmetric. If your nipples were not at the same level before surgery, they will not be after. On the other hand, your right implant appears to be higher than your left implant and it does not appear to be centered behind your nipple. Consequently your nipple appears to be rotated downwards and this would accentuate any pre-existing assymetry. Changing implant size alone will not change your nipple position. 

You also stated that your left breast was too high and small after your first surgery. This sounds like it could have been due to capsular contracture which tends to produce that kind of appearance, rather that just malposition and/or implant missizing. It also appears that you surgery was done through a peri-areolar incision. This incision is associated with a higher incidence of capsular contracture which would fit with your circumstances. Also, your photo demonstrates another disadvantage of the peri-areolar incision. You have had one revision through this incision and the scar is already retracted, causing some distortion of your areola. Any additional surgery through this same incision is likely to result in further retraction and distortion of your areola, so I would avoid re-using that approach.

I do not think you have pseudoglandular ptosis. From your current photo, your left breast seems to look pretty good. The implant is lower providing more fullness and roundness to your lower breast, thus making it look bigger. Your right implant looks too high and it does not fill out the lower breast tissue, rather than the breast tissue secondarily sagging on the implant. This could be result of implant malposition, or could also be caused by capsular contracture. So your situation appears to be complicated. I think you would benefit from a second opinion. Revisionary breast surgery can become exceedingly complicated and you might consider seeking out someone with a good deal of experience in breast implant revision. 

Concerns about Breast Asymmetry after Breast Surgery?

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Thank you for the question and pictures.

 Although the breast asymmetry that you are referring to is visible in the photographs you have posted, I would suggest (considering your surgical history)  that you avoid any further surgery at this point. I would suggest you allow your breasts to continue to heal and the breast implants to take their final position. Evaluate the end results of surgery approximately one year after the last procedure was performed.

 At that point, if your breast asymmetry is mild, I would probably suggest that you avoid any further surgery.

 Best wishes.

Symmetry after Augmentation and Revision

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Without an in-person consultation or at least some photos it's hard to say, so that would be my first recommendation-an in-person meeting with a board-certified plastic surgeon, preferably one that specializes in breast revision procedures.  We are very experienced in correcting mistakes and revising breast implants, lifts, and reductions.  A bit of asymmetry is natural in all women, but if you are unhappy with the look, feel, and shape of your new augmented breasts you should seek a second opinion.

Norman M. Rowe, MD
New York Plastic Surgeon
4.9 out of 5 stars 62 reviews

Sometimes it's best to leave well enough alone.

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Based on the submitted photos, your breasts look pretty good although it is clear that some healing is in front of you.  The breasts are as symmetrical as nature allows.  I would advise you to leave well enough alone.

Breast Symmetry after Augmentation

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I would really need to see your photos before surgery to give you an adequate answer. To my eye, you have a bit narrower breast on your left, and a wider breast on the right.  These differences in the skin can't be easily changed by manipulating the implant.  Likewise, your left nipple naturally sits a bit more the the outside of the breast than your right.

I also notice that your breatss have not quite stretched out over the implant yet.

I think you may get a bit more balanced result as time goes by and I would suggest photos every month to follow these changes.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 276 reviews

The enemy of good is perfect

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So far your results look good and although I respect the fact that you may not be completely satisfied with your results the reality is that it is normal to have some degree of asymmetry depending upon what you looked like in the beginning.  Every time you undergo additional surgery you risk making things worse and will develop even more scar tissue.  So you might want to consider staying where you are and not consider additional surgery at this time.  good luck

Breast asymmetry after augmentation

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is usually due to breast asymmetry after augmentation.  It is extremely rare to have perfectly matching breasts and implant will only make what you have larger and fuller.  If you're happy with your look in your clothing and when undressed, nothing needs to be done.  If there is a major, obvious asymmetry of the nipples, you can consider nipple lifts if needed and you are willing to accept the risks and possible additional costs.  Your photo from the view you took showed good results.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast asymmetry

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No two breasts are exactly the same, and some asymmetry is normal.  For you it would have been nice to see earlier photos.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Pseudoglandular ptosis following breast augmentation surgery and revision

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Breast are sisters they are not twins and unless they started of perfectly symmetric they will never end up being perfectly symmetric.  Some of your problem, as evidenced in your photos, is pseudoglandular ptosis or sagging. The implants are behind the muscle and there is just a small amount of excess breast tissue that did not get fully expanded with the implant.  In other words, the implant was not able to push out and fully expand the breast pocket.  It may not be possible to make your result any better than it is right now.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews


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As a woman you will never be 100% symmetrical that is very normal for every women. Without seeing a picture or an exam it’s hard to be exact on what your options can be.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

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.