Would This Type of Asymmetry Be Fixable Without an Implant? if So What Procedure? (photo)

ideally i would like them to both be round rather than diagonally oriented. I would like my nipples to have a significant amount of tissue below them so they can be in the middle of the breast. is there any way to achieve this result without an implant? the difference is about one cup size between them. 32D and C respectively. so at this size, i'm really not looking for more volume.

Doctor Answers 13

Correction Of Breast Asymmetry

Your breast shape and symmetry can be improved (I am not sure fixed is the right word) without the use of implants. And implants in your case are not that helpful unless you are after a big change in size increase. Some form of breast lifts are needed that may have some differences in them between the two sides. The nipples can be lifted and the breast mounds reshaped. But there will be a trade-off of scars for this change so be aware you are trading off one aesthetic problem for another. The real issue in your breast concerns is not whether an implant is needed but whether the scars that will result from the lifts are worth it.

Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Breast asymmetry

If the nipple areola position is not moving up alot, it is very difficult to swing them into the center of the breast.  Sometimes with a circumareola appraoch like breasts similar to yours, they can be cheated over a bit.  Impalnts may help with the overall shape.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast asymmetry can be corrected without implants

Breast shape and size difference can be corrected without breast implants by using a combination of fat transfer, scar release and breast reshaping.  The results can be extremely pleasing and actually require less surgery than would be needed if implants were used.

To improve the overall breast shape in reference to nipple position a breast lift should be considered at the same time as the fat transfer.

A surgeon experienced in treating complex breast shape problems should be consulted to ensure an optimal outcome.

Mario Diana, MD
Plano Plastic Surgeon
4.5 out of 5 stars 28 reviews

Improving Breast Symmetry?

Thank you for the question and picture.

Without the use of breast implants your best option may be breast reduction/lifting on the left side in order to match the right side as much as possible. I'm sure you understand the absolute symmetry cannot be achieved. On the other hand, in order to achieve a “round” look pressing plants may be necessary.

I would suggest in person consultation with a well experienced board-certified plastic surgeon.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Breast asymmetry is well corrected without implants.


1)  For your right breast, I would recommend a breast lift which would also make your areola a little smaller and move your nipple to the center.  Size stays the same.

2)  In your left breast, you need the same procedure combined with a small breast reduction to make the size the same as the right.  The left areola needs to be made even smaller.

3)  How the lift and the reduction are done is very very important for good shape and long term result.  The best is the internal vertical (lollipop scar) Lejour operation, which re-shapes your breasts from the inside and does not rely on pulling the skin.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast Asymmetry

Hello Theresa,

There are two issues being bantered around here: shape and volume.  Both are asymmetric in your case.  You were very specific about the desired appearance of your breast with regards to nipple position, and your request could only be achieved with a breast lift (breast reduction for the left side).  This will give you much better symmetry in mound shape and nipple position than anything else, especially a one sided breast implant.

Subsequent to this procedure a breast implant may give you better upper pole and inner breast fulness.  Many women can have both the lift/reduction and the breast implants placed in one procedure, however given the nature of your breast asymmetry a two staged procedure will give you the best chance of getting symmetry.

Fat grafting breast augmentation is a hot topic in plastic surgery.  There are only a handful of people who are doing the proper research on the subject.  To summerize, it is a prolonged and less predictable process.  In the best of hands, using stem cells and vacuum bras for weeks, approximately twice as much fat is needed to be grafted to achieve the desired augmentation.  My recommendation is to abandon the desire to augment the breast or utilize breast implants for breast augmentation.

To be certain, your situation is very difficult to correct.  You appear to be young, and have very elastic skin that is difficult to stretch and appears 'tight'.  (Ironically, this is also a good thing.)  Any potential surgery should not be performed by the average plastic surgeon, never mind the ear, nose and throat doctor doctor that also does liposuction and breast implants on the side.  You should seek out a breast specialist with a great reputation for breast surgery and revision breast surgery.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

You will breast lift and not implants

There are many different options. You have stated that you want them both ROUND and higher nipple position. You do not need implant for that and implants will make the problem worse. You will need to have lift to reposition the nipple and change the breast shape. I would recommend some reduction of the left breast and fat grafting for the upper pole fullness and symmetry.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

Correction of breast asymmetry

There is always the option of reducing the larger breast and elevation of the nipple. However, as others have noted, true symmetry cannot be achieved although your condition can be improved. The crucial thing is to understand your own expectations and the limitations of correction and then to choose an option and surgeon with whom you are comfortable.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast asymmetry without implants

There are two factors in breast asymmetry, volume, and the shape of the skin envelope. If you decide that the larger breast is the 'best' size for you then fat grafting is an option to be considered, though you will not have a good chance at correction of the nipple level unless the breast envelope is adjusted with a lift. If the breast scar is acceptable then you should also consider a reduction with lift on the larger side. There are many options, all with compromise, so take your time.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Many different opinions

The worst procedure would be fat grafting. The simplest would be an implant on the right. They will never be exactly even. You might get away with liposuction on the left to bring it down one size, but then there will be nipple asymmetry. See a well qualified board certified plastic surgeon and discuss all of the options. There is no one right way to go.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.