Uneven Breast After Augmentation. Will my Doctor Fix This? Do I Have Pay Again?

I had my breast done on January 5th,2011. Almost 3 months now I still feel that my right breast is bigger than the left one. I also think that they are different shape. When I told my dr about it. He said that my right/b was bigger with one teaspoon and was not a big deal. But I can see that they are different size and shape. I was a B/C. he put 440 on the L and 435 on the R. Will he fix this at no cost or I have to pay for it if I asked him to redo it? my breast were always different size befor

Doctor Answers 16

Most patients aren't perfectly even

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When patients seen in consultation, I tell them, I don't do "perfect", but I do make them look better. As one or the other physician stated, patients aren't symmetric. One of my esteemed professors Dr. Frank Gerow, a brilliant plastic surgeon and will one of the developers of the breast implant, once said to me that if you point out imperfections to a patient before surgery, they are considered an anatomic variant. If they point them out to you after surgery, it's your mistake.

Looking at the photographs, I don't see much of a difference between the two breasts. In terms of size difference, I've always gone by the rules that there has to be at least a 30 mL (1 ounce) difference in volume up to implants for there to be a visible difference.

You may have a visible difference postoperatively that wasn't there preoperatively, if one of the pockets is developing a thicker capsule.

Houston Plastic Surgeon
4.3 out of 5 stars 27 reviews

Asymmetry is normal. Nobody is perfectly symmetrical

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your pictures show a very nice result.  You were not perfectly symmetrical before surgery (nobody is) and you are not now.  Certain features of your breasts do not change by the addition of extra volume (implant), your breasts (with all their asymmetries) just get bigger.  Before surgery you were used to the way your breasts looked and you did not see the differences, or if you did you didn't really pay much attention to them because you were used to them.  Now that you have implants your point of view has changed and you see things that before (although they were there) you didn't care about.  As time goes on you will once again get used to the way these breasts look and it will not bother anymore.

You must realize that adding two identical breast implants into two non-identical breasts is not going to improve or worsen the asymmetry, it will only change how you see yourself and suddenly you see things you didn't notice before.

Congratulations on a very nice result.


Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Asymmetry is accentuated following breast augmentation in most cases!

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You had a mild asymmetry to begin with and a mild asymmetry following breast augmentation. This is not unexpected as all breast are asymmetric.  The thing that wyou really need to think about is the fact that with each surgery the risks such as capsular contracture increase to more than double. Therefore, since you have a very aesthetic result with an asymmetry that is likely no more than what you had prior to the implants (assuming the implants placed are the same size), I recommend you enjoy your beautiful breast and avoid additional surgery as long as possible.  If you were to have a complication such as a capsular contracture, which is a know risk, and surgery is inevitable, you may consider putting a larger implant in the smaller breast to achieve better symmetry.  If you were to develop a capsular contracture, this would unfortunately not be the financial responsibility of  anyone but your self.  If the implant ruptures, the company will usually replace it at no cost, but the patient is still responsible for surgeon, facility and anesthesia fees.  I hope this has helped.

Good Luck.

Kimberley Lloyd O'Sullivan, MD
Providence Plastic Surgeon

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Uneven Breasts After Augmentation

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Thank you for posting the photos. First, this is a very good result and at three months you are still healing. Second, any preoperative asymmetries may persist post-operatively. As plastic surgeons we strive for symmetry, but we cannot guarantee perfect symmetry. I personally don't think you should have a revision as it potentially introduces a set of potential complications, such as capsular contracture, bleeding, and poor healing. Even if these risks are low, they still exist. As far as paying in a revision case,the policy varies from one plastic surgeon to another, so you would have to ask your plastic surgeon what their policy is.

Hope that helps and good luck!

Dr. Babak Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 51 reviews

Who pays for redo of uneven breasts after augmentation?

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As my colleagues have already stated, your breasts did not start out exactly symmetrical, and the difference now is present, but truly minimal. What is NOT minimal is your anxiety over this, which should be less at least until everything has completely healed, settled, and softened!

Even when we perform the same exact operation on each breast, EVERY patient has some difference in the swelling, bruising, discomfort, firmness or softness, position, sensation, and shape between the breasts. If you look closely at your pre-op photos with your surgeon, you will almost certainly see some subtle differences you didn't really notice before. But now, after surgery, you're looking much more closely, and your mind "magnifies" each and every slight difference. Did you know that your right chest wall is probably flatter and slightly wider than your rounder and narrower left chest wall? (This is because we each have a heart on the left side, and the ribs curve around this organ). Your breast measurements (if your surgeon recorded them) prior to surgery were almost certainly not identical either.

I would not recommend any re-operation at all right now, and at 6-12 months, if you still look this good, I would probably recommend against re-operation then as well. If this continues to bother you, your surgeon and you should already have discussed revision or touch-up surgical fees before your first operation. Even if re-operation was "free" I would seriously consider that you could be risking a WORSE result than you have now.

Remember, the enemy of good is better!

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

Asymmetry after Breast Augmentation

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No two breasts are identical.  Review your before surgery photos to remind yourself of your natural pre-existing asymmetries.

Your photos do not suggest any need for revisional surgery.

Stephan Baker, MD
Miami Plastic Surgeon

No one is completely symmetrical

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I agree with other comments.  You have a very good result.  I personally do not see the asymmetry that you do.  I would caution you not to make conclusive judgements and/or decisions so early in your postoperative course.  your result is going to change more over the next 6-9 months and if you make a judgement now, you could be in error.  Give it time and then after 9-12 months you feel the same way, discuss it with your plastic surgeon.  We all want our patients to be happy but sometimes the risk/downside of additional surgery is not worth a small improvement.  Remember that every time you have surgery, there are associated risks.  So  don't risk a good/tgreat result in pursuit of perfection.

Tracy M. Pfeifer, MD

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

You have a great result

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I agree with the other postings that you have a great result.  There is always a small degree of asymmetry.  I like to say, "they're sisters, not twins."  Nonetheless, it is always important to chat about your concerns with your surgeon.

Uneven Breast After Augmentation. Will my Doctor Fix This? Do I Have Pay Again?

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From the so kindly posted photos, to me you have an excellent result. Very "minor" differences. The issue is realistic expectations. IF you have saline implants & could additional saline be added to the left- sure. But look at the risks. Infection, capsule formation. And if silicone than a new implant is needed, which has a cost. I would discuss these issues in detail with your chosen surgeon and if you still desire a "fill up" than go ahead, the risk now fall more on your head. From MIAMI 

Symmetry after breast augmentation

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The truth is that almost everybody has one breast that is slightly different from the other, either is size, nipple position, and skin envelope shape. Breast augmentation can adjust for some differences, though if you look hard enough, one breast will still have a characteristic or personality different from the other. Your photo and result look quite good. Perfect is hard to come by.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 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.