Uneven Breasts 6 Months After Augmentation - Revision Needed?

It's not unusual for patients to have asymmetry following breast augmentation surgery. This is a normal finding and occurs to some degree in almost everyone who undergoes breast augmentation. Asymmetry can occur for a variety of reasons. It's often due to factors that can't be controlled by the surgeon. It's often related to baseline asymmetry of the breast tissue, nipple areola position and underlying chest wall.Your pictures suggest a superiorly malpositioned right breast implant. This could occur for a variety of reasons, but after 6 months will probably require some type of revisional surgery.  It's virtually impossible to make a recommendations without pre-operative pictures and a physical examination. For these reasons, it's appropriate to contact your surgeon as soon as possible. Your surgeon should be able to address your concerns.

YOur results appear to demonstrate the settling and dropping of your left breast implant relative to your right. My advice would be to wait until 9 months but it is my opinion you will require a left sided breast implant capsulorrhapy and possible implant downsizing.

Your result is unlikely to change after six months.  At this point to achieve symmetry you will need revision surgery.  Revisit with your surgeon and possibly get several other opinions from board certified plastic surgeons in your area.

Good Luck.

Dr. ES

Thanks for including your pictures.  If would be nice if you had pictures from a few different angles.  At six months, the implants are pretty much settled.  It would be interesting to see what your pre-operative pictures look like to evaluate for any pre-operative asymmetry.  However, secondary surgery may be able to help with the asymmetry, but as with most patient, it is impossible to make you exactly symmetric.  Good luck with your recovery.

YES! Sorry. Seek opinions from boarded surgeons in your area or return to the surgeon. You chose. BTW thanks for the photo, it helps.

From MIAMI DR. B

Your photo is not exactly face on, but it appears to me that your implants are indeed somewhat asymmetrical with the left implant being lower than the right. This causes your left nipple to be positioned higher on the breast mound. I think that your left crease is correspondingly lower than the right, and that probably these differences will not change with time. Correction would require either lowering the right implant, raising the left implant, or both. Usually this works, though there is some risk of the implants again being different. Incidentally, all plastic surgeons who perform breast augmentation will have occasional problems like this that require a touch up. Good luck! 

Breast asymmetry is the norm rather than the exception. Without seeing your pre-op photos it is hard to say what you need.  If you want the right breast lower, you may need to go back into the OR to try to lower it some more.

You have significant asymmetry between the breast implants/ inframammary folds.  This still may settle.  I would give it up to 6 more months.

Although the photo helps, I would agree with others who indicate that it's not possible to judge the cause or degree of asymmetry based on the one view which is not quite a straight front shot. 

If the left side is settled and correctly positioned then the right side was probably held up by blood or fluid in the pocket that kept the implant too high during the healing and settling process. It would be acceptable if the left side matched it but the two look different because of where the implants healed. 

Generally the tissues are recovered by two to three months after breast augmentation and further time after six months isn't going to accomplish anything. There are exceptions. What I use to judge this is to check monthly after the 2-3 months and if there is no change with either side then assume it's not going to change. If it's still changing then it's best to wait even the full year. 

If the implant on the right remains too high relative to that on the left, the solution is to use an inframammary crease incision approach, remove the implant temporarily, open up the capsule over the entire lower pole (capsulotomy), leave the inframammary crease in place (assuming it was even), and replace the implant. Watch for blood or fluid collection in the space after the procedure as this could cause the problem to recur. 

Hi.

1)  The folds under your breasts are even.  So you wouldn't want the left breast to drop.

2)   You may have had some asymmetry before surgery.  I think your left nipple will always be a little higher.  In any case, your breasts will not change on their own. You can consider a  revision breast augmentation, but you don't have a bad result.