Do I need two different size implants? (Photo)

Question

Hi everyone, My right breast is slightly smaller than my left breast, although I am aware this is fairly common. I asked my doctor if I should use a slightly larger implant for my right breast to make up for the difference in volume. He explained to me that he usually reserves that for patients who have a significant difference in volume between their breasts and that mine are similar enough that he worries using a different sized implant might actually worsen the end results. Thoughts?

Scott W. Vann, MD, FACS · Answer

With the photo i think you probably do have maybe 25ccs difference in your breasts. i would have you try on sizers of same size and then with 25cc difference and let you pick which you think looks best. Good luck.

William Andrade, MD · Answer

Hello, I frequently use differently-sized implants to help correct a slight size difference.  I agree with your surgeon that perfect symmetry may not be achieved because even if two different size are inserted, they may not correct all the subtle shape differences of your breasts.  However, in many cases I find it is possible to make the breasts closer in overall size and symmetry.

Caner Kacmaz, MD · Answer

Breast implants are sized according to their volume in cubic centimeters (cc).

How do you know what size implant to choose? Looking at pictures and talking to friends who had a breast augmentation might help.

Off course the volume will depend on the shape and size of your actual breasts, your frame and the size you want to achieve.

Our plastic surgeon will advise you thoroughly. Bringing pictures of a desired restult to be shown to our surgeon, might be very helpful.

Donald R. Revis Jr, MD · Answer

Good evening!
I perform over 500 augmentations a year, and about 1/3 of patients need two different sizes. I cannot tell from your frontal photo alone, so the difference isn't that much- at most 25cc. This type of fine tuning really needs to be done in person with your PS.

Gary M. Horndeski, MD · Answer

Your breasts are slightly asymmetrical in volume. You appear thin but if you are happy with the size of the larger breast then an alternative to consider is fat transfer to the smaller breast. Small amounts of fat may be effective. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Fat transfers are permanent and incorporated into the body.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Kind91261,
based on your photo, it looks like you have some asymmetry and different size implants would improve it. Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

I actually agree with your surgeon. You don’t have enough asymmetry to justify different size implants. A lot of times you simply can’t win the different size implant game. Obviously other surgeons will use different size implants. It’s up to you to decide which approach makes the most sense.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  Although more images would be helpful to provide the best answer I would in fact use slightly different size implants to improve upon the volume differences.  This assumes a smaller overall size of implants where the interval between the sizes is narrow, compared to larger implants where the sizing differences are greater.  Hope this helps.

Connie Hiers, MD, FACS · Answer

If you have saline implants, the volume in each could easily be varied to make you more even. If you chose gel, two different sizes could be tried on the smaller breast to see which one is closer in size to the larger breast.

Raghu Nandan, MD, MPH, FACS · Answer

Dear Kind91261,
Sizing and selection of breast implants is highly patient specific. Based on the picture, there is not a significant size discrepancy between both the breasts and I agree with the plastic surgeon that asymmetric implants may not be needed in your situation, and may actually cause asymmetry. Good luck!