Uneven Breast After Augmentation, What is Wrong? (photo)

I had a breast agumentation 2/16/2012. The surgeon measured both my breast as being even to begin with so he went with 400cc in both breast silicone mentor unders. Swelling seemed even but I did notice my left side was alot more tender and sensitive to the touch alittle better but still sore. Now as the weeks go on I have noticed a big difference in size.The right one is alot more full and lower than the left one. What is wrong?

Doctor Answers 10

Breast and symmetric healing after augmentation

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Thank you for your question and for sharing your photos. During the post-operative period the breast are swollen, and the breast implants appear in a much higher position. Over time they descend and fills out the lower half of the breast. In addition, it is not uncommon for one breast to be more swollen than the other and may even out with time (unless they were asymmetric in size to begin with). It may take several months for this to happen and can be encouraged with breast massage and compression. It may appear that the breast enlarges as the lower aspect of the breast fills out (at the expense of the upper portion of the breast).

Breast asymmetry

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Thanks for your question.  You breasts are currently asymmetrical, I agree, but you still have time to develop symmetry through the effects of time, gravity, massage, and a device called a bandeau.   Please discuss with your plastic surgeon, good luck.

Uneven breasts after augmentation

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Your size looks the same. One implant sits higher on your chest. It should settle in place in 6 weeks.

Why does it happen? Your implants are under the muscle The muscle has to stretch. Until it does, tight muscle pushes implants up. It more common on the dominant side, ie if you are right handed it tends to happen on the right,  you use those muscles more. My recommendations:

  • massage the higher side putting firm pressure on the muscle to relax it.
  • Avoid upper body weights or exercise if possible until the implant settles.
  • Have your surgeon check you 6 weeks from surgery.

Best of luck - and don't worry! 


Uneven Breast After Aug, What is Wrong?Answr:

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It looks like to me that your one breast is just a bit higher than your other and this usually makes them appear smaller, since they are less full down below. So you are a little over one month and I would really massage the higher breast back and down, much more than the other and I think in 6-8 weeks, they will be so close that only you will be able to tell..and your result will be great...

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Post Op Breast Asymmetry

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If would be best if you post pre-op pictures as well so that we can better evaluate your post op results.  However, with just one month since surgery, there is still time for the swelling to resolve and the implants to settle.


Good Luck.

Uneven post op after breast augmentation

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It is normal to have some uneven swelling and some uneven positioning after surgery. Likewise, it is very probably that you had a different level in the inferior fold of your breast and with your augmentation it has tomporarily become more noticable, tis should improve as the swelling goes down and the breasts start to soften.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Breast asymmetry

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My guess is that the two breasts have some asymmetry.  You ahve to give them time, but they will more than likely always be asymmetric.

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

Asymmetry with Breast Augmentation

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From your photos, it appears that you have some breast asymmetry. However, this is not overt and could easily be part of the healing process - always one side will progress at a different rate than the other. The breast crease or fold does appear at different levels which may contribute to one looking lower and less prominent that the other, but this is likely to be something that existed before surgery. Look at photos to make that determination. Be patient and watch to see how things evolve as you fully recover and stay in contact with your surgeon. Best of luck, Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Postop breast asymmetry

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As we write frequently on this site, swelling can occur differently in the breasts and then resolve at different times. The left breast, which you report as more tender, hasn't dropped as much as the left one. I recommend patience and continued followup with your plastic surgeon. At this point, don't assume that anything is wrong but be vigilant.

Asymmetry 1 month after breast augmentation does not always mean something is wrong!

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You do have some asymmetry in your breast appearance, due primarily to the different implant positions relative to each nipple/areola position (your nipples appear to be fairly symmetrical related to your collarbones). One implant is higher (the left one, by your description, and the breast to the left side of the [mirror] photos you kindly supplied), and that breast exhibits not only increased superior fullness, but also a higher inframammary crease than the opposite side.

Once that implant drops (assuming it will drop, but more about that in a moment), and only if the other implant does not drop a similar amount, your lower breast fullness will look more equal between sides, and the excessive fullness I see on your left side superiorly will diminish.

If in fact you are beginning to develop capsular contracture on the higher, tighter, "more sore" left side, then you may see no "settling" or further dropping on this (left) side, which to my eye also looks larger than your right side.

Size discrepancy is another matter entirely, and may be due to pre-operative asymmetry, post-operative swelling differences, or even a collection of (more) blood or fluid on the "larger" side. Although early, the high, tight, and "sore" (left) side may be exhibiting early signs of capsular contracture, but you stated the lower right breast seems more full. Without physical examination none of us here can be certain, but your photos seem to show the higher (left) breast as being the larger of the two. This does not correlate with your description, but this happens with some of my patients as well, since positional differences can simulate volume differences.

Assuming everything is healing properly, without hematoma or seroma or capsular contracture, wearing an elastic bandeau above the higher breast and below the lower breast (safety pin the bandeau to an overlying T-shirt to keep the elastic bandeau in proper position) will help to maintain the "lower" breast's position with less additional "dropping," while aiding improved downward movement of the "higher" breast's position to a more symmetrical final result. This may take weeks to months.

Bottom line: at 1 month this is still early, and I would continue follow-up visits with your surgeon and carefully follow his or her advice as healing progresses and swelling diminishes. Nothing at all may be wrong, and in fact that is probably the case! Residual asymmetry in volume and position (or treatment of capsular contracture) can be taken care of by revisional surgery. Though neither surgeon nor patient wants another operation, both must wait for at least 3 months (6 months is better) to see how things end up. Operating on a "moving target" is foolish and much more prone to failure. so both surgeon and patient should be patient, and do their best to modify the healing process to maximum improvement in the meantime. Best wishes! 

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 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.