1 year post op, boobs are still uneven. Any suggestions?

I got saline under the muscle breast implants and it has been exactly a year and my right boob seems way more natural and has dropped more than my left ! With a bra on it is not noticeable but once it comes off it is pretty bad. What can I do? My scars are under my armpit due to the fact I did not want any visible scars.

Doctor Answers 20

Uneven Breasts

It appears that you have a capsular contracture. It will almost certainly not get better on its own. A capsuloplasty or capsulectomy procedure should soften and make the left breast symmetrical. A new implant should also be placed which will lesson the chance of the contracture recurring. Unfortunately, you cannot use the scar under your armpit to have this correction performed. A new incision will need to be made either around the nipple or under the breast crease. 

Uneven breasts

Dear kaye c,

Thank you for your clinical post. From the photograph showing the right breast has a more natural posture and the left breast appears much perkier with less droopiness. Without more information it’s difficult to surmise the exact cause of the asymmetry, the right side may have been your larger breast, a little more ptotic pre-operatively or the left side may have undergone a capsular contracture or some combination of those two processes.

At this junction the best option is to revisit with your operative plastic surgeon to discuss the options after a full clinical examination. There will be lots of options depending upon the cause of the asymmetry and you should be able to arrive at a more satisfactory aesthetic result.

I hope this information is of some assistance and best of luck.

To find out more, please visit the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 80 reviews

Follow up with your surgeon

You should follow up with your surgeon to see if you might need revision. It is impossible to help you without an in person examination. 
Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices.

Visit your PS

Thank you for the question. If your breast is hard and in pain, you may have capsular contracture.  You may need a revision surgery. So best to follow up with your board-certified plastic surgeon andget a full evaluation.Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 57 reviews

Breast issue

You may have a capsular contracture and should be evaluated in person. Best of luck. It is also helpful to see preop photos as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast asymmetry

Thank you for your question and pictures. Is your left breast hard and the right breast soft? If so you may have a capsular contracture on the left side and a normal right breast which will require additional surgery on the left side. It is best that you make another appointment with your plastic surgeon and discuss your concerns.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast asymmetry 1 year after surgery: transaxillary approach

It is difficult to know for sure what is going on without examining you.   In general transaxillary approach has an advantage in scarring, but it is impossible to be as precise in surgically creating the pocket.  If the pockets are very different that could be a reason for the asymmetry.   Another issue with the transaxillary approach is the increased chance  of the implant coming into contact with the skin with some skin bacteria adhering and causing a late capsular contracture.   If the asymmetry has progressed over time, that is most consistent with capsular contracture.  In any case your only solution is revisional surgery which will have to be done from an incision below your breast.  The evidence for treatment of significant capsular contracture with change in shape without surgery is  limited.

Assymmetry one year after breast implants.

You will need an operation to get better symmetry - I would recommend discussing with your original surgeon, as there may be some accommodation for revisionary surgery.

Check with your surgeon

Your surgeon will have your pre-op photos and recovery photos to compare with your current photo.
An exam will help determine if this is related to scar contracture.  
Either way, more surgery to release the implant will probably be necessary.  

1 year post op, boobs are still uneven. Any suggestions?

Thanks for your question and picture.  I am sorry that you have not had the outcome you desired after surgery.  After 1 year, your appearance is not going to change significantly without intervention that likely involves surgery.  You would need an in person exam to determine the issue with the left breast.  It is likely either capsular contracture of the implant or an incomplete release of your muscle at the original surgery.  Meet with your original surgeon to discuss your issues.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 58 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.