Uneven breasts 5mo post Breast Augmentation with 250cc silicone implants in both breasts - Scoliosis? (photo)

I am 5 months post BA and concerned about my uneven breasts (see photo). My left has dropped fine (possibly too far now!). My right dropped some early but has not moved in the past few months. I do have scolios and some rib malformation and dont know if that has played a part in this? I have read about pocket revision and wonder if that may help? Any suggestions or opinions would be helpful. These are both 250cc under silicones. Wondering if mine will ever be normal & even. Thank you!

Doctor Answers 8

Implant malposition

It appears that  your right implant pocket was not made low enough on your chest wall.  The implant is riding too high in comparison to your breast, which makes the nipple appear too low.  I suspect that your right nipple is naturally lower than your left.  Your pre op photos would be helpful regarding this.  Nonetheless, you need the right pocket lowered.  Your implant may need to be changed as well as the warranty is voided once you reoperate.  I don't think your scoliosis is the culprit here.

Philadelphia Plastic Surgeon
4.8 out of 5 stars 21 reviews

Implant malposition

Based on your photos, your right breast implant is sitting a little too high.  The left side looks great.  I would recommend that you first try non-surgical treatment with a combination of aggressive implant massage and a drug called Accolate to soften the capsule.  I would try this for at least 6 weeks, and preferably 3 months.  If things don't improve you will need a revision with implant repositioning on the right.  This is a pretty minor procedure, which can be done as an outpatient in about 30 minutes.

Robert Stroup, Jr., MD, FACS
Cleveland Plastic Surgeon
4.6 out of 5 stars 18 reviews

Breast asymmetry

It looks like your right implants has not come down enough and you probably need a revision.  I do not think the scoliosis has anything to do with it.

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

Breast Asymmetry

Hello Jael,

Unfortunately you will need a revision surgery to improve your asymmetry.  I do not think your left implant has dropped too much. Scoliosis has not played a part in your problem. The cause of the right implant getting 'hung up' cannot be determined by your photo, but the solution is to either remove some or all of the scar capsule from around your right implant. That alone will do three things immediately: bring the right inframammary fold down to match the other fold, bring the top of the right implant down, and rotate the nipple-areolar complex up.  After this type of surgery, the inframammary folds should be perfectly symmetrical immediately, however the top of the implant and the nipple-areolar complex although improved, will require a few weeks before settling to their final position.  

If it was determined in a few months after this type of surgery that a lift was needed to achieve better symmetry of nipple position, a circumareolar lift should be performed under local anesthesia; an office procedure.  Otherwise known as donut/Benelli/periareolar lift, it can move the nipple-areolar complex a small distance and still control shape and size of the areola, unlike a crescent lift that will elongate and distort the shape of your areola.  Having said that, I believe that you will probably not need a lift due to the effects of the right implant dropping, combined with the simultaneous expansion of the skin of the lower pole of your breast, both allowing the nipple-areolar complex to rotate up.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Symmetry and shape can be improved with revision breast augmentation.


You might not end up with perfect symmetry, but you can definitely do better than this.  I am afraid things will not improve on their own.  You may need revision of the right breast, lowering the fold and putting in a slightly larger implant.

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

Breast asymetry. What is the cause?

The basic issue is the nipple-areola complex is low on the right, naturally.  The breast implant on the right is slightly high. 

The solution is to do a crescent lift on the right to elevate the nipple and bring the breast implant down. This should even out the breast.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 75 reviews

Breast implant asymmetry

From the photos you have included it looks like there are two points of asymmetry.  The right implant is too high and the right nipple is a little low relative to the left.  The combination makes the asymmetry appear even more severe.  

The implant position can certainly be adjusted and it is a fairly easy procedure that can be done with local anesthesia if desired.  I suspect the right nipple was lower than the left before surgery and this may require a lift for symmetry.

From the view you have included, it looks like scoliosis isn't a significant cause for the asymmetry.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 175 reviews

Scoliosis and Breast Asymmetry after Breast Augmentation?

Thank you for the question and picture.

The breast asymmetry that you are referring to is clearly visible in the picture you provided. As you mentioned, this may be related to existing chest wall/breast asymmetry (secondary to scoliosis)  and/or asymmetrical “descent” of the breast implants.

It is possible that you will benefit from revisionary surgery;  this procedure may involve  repositioning of the right breast implant (by working on the right breast implant pocket)  and/or use of different size/profile of breast implants on the right side.  if you are happy with the left side (which appears to be in good position),  the left breast implant does not have to be manipulated.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 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.