Uneven Cleavage After Breast Aug? (photo)

9 months post surgery. I was originally an A cup. i had a little bit of an uneven chest wall, right side is higher than my left. But my left breast sits higher than my right. We did 350 cc mentor gummy bear implant under the muscle. During the surgery my doctor put 350cc on my left and used 300cc on my right because of the chest wall. Now my issue is I'm having a lot more cleavage on my left side. Is this because of the chest wall or should he have gone with the same size implant as my left?

Doctor Answers 8

I see a couple of problems making your breasts uneven

In addition to the asymmetry created by the volume difference between the implants, it also appears to me that the left breast implant is rotated.  You reported that you have Mentor "gummy bear" implants, and that implies to me the CPG shaped implants.  As you may or may not know, shaped implants have a possibility to rotate, and when they do, they look much the same as your left implant.  Being shaped implants they have a distinct long and short axis, and unlike a round implant which will have the same shape no matter how much it rotates, a rotated shaped implant will take on a different projection depending upon its rotation or orientation.  Thus, because the long axis of your left implant is rotated counter clockwise with the apex of the implant at approximately 11:00, it is causing irregular projection in the area of the cleavage.  In addition to this, you note that you have a 50 cc difference between your implants, and this is typically a noticeable amount of difference.  The thing to remember with different volumes of implants is that volume is not the only variable that changes - you also get wider base widths, in the case of shaped implants longer heights, and higher anterior projection.  Thus, not only does your left breast have more volume, it is also "bigger" in that the footprint is bigger than that of the right.  This will cause a noticeable difference in shape between the breasts, especially in a form stable solid gel implant like the CPG.  This will cause its own asymmetry even though you are trying to correct an existing natural asymmetry.  You may need to have your left implant not only repositioned but also replaced with a 325 cc implant to acheive OPTIMAL, not necessarily perfect, but OPTIMAL symmetry.  You should have a very detailed discussion with your surgeon about this.  Good luck.

San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

Slight asymmetry after breast augmentation should probably be accepted.

Breasts are not perfectly symmetrical before breast augmentation so slight asymmetries after the procedure should probably be accepted. The breasts pictured looks natural. I would leave them alone.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Breast asymmetry after augmentation

will persist as yours does.  You have very good results and most people would not even appreciate what you see.  That being said, you had a choice of using the larger implant on the lower side to make your breasts project equally or to use same sized implants and have your more prominent side always stick out more.  If your implants are mobile and you can squeeze them together like a push up bra, I personally would not recommend anything else.  I really do think they look great.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast augmentation asymmetry is about shape, not just size.


The sizes are pretty good.  The cleavage edge of the left implant is much more obvious, and that is what creates the asymmetrical look.  Cannot tell you if this can be fixed without examining you.

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

Asymmetry following a breast augmentation

There is some confusion about the type of implant that was used. But in any event it is difficult if not impossible to correct every asymmetry.  Asymmetries can be from several different anatomic features including differences in volume, the shape of your chest wall etc...  If you have some degree of scoliosis this can account for some asymmetry as well.  Without a pre-operative photo it is not possible to fully evaluate your result or improvement in the degree of asymmetry.  The goal is to make the breasts evener but absolute symmetry is often not possible to achieve.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Rotation of form stable breast implants is a risk if not placed properly

You mentioned the use of a Mentor 'gummy bear' implant - which implies a form-stable CPG implant - currently not FDA approved, but there are a few surgeons out there permitted to use them under study protocol. If you truly have a shaped implant in place, it appears the left implant has rotated counter-clockwise a few degrees, changing the shape of your left breast. This can happen with any shaped implant, and its important to carefully dissect the implant pocket and use a drain when using these textured devices.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Gummy Bear Breast Implant

It is difficult to say from your photos, but if you truly have the "gummy bear" which is the form stable implant, then is it possible as previously stated, that the implant has rotated on the left side.  From the photos also it may appear that the crease is a bit higher on the left.  Again, the best way for some one to tell you what can be done would be to have your breast examined.  Make sure you choose a board certified plastic surgeon.  Good luck, hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

Uneven cleavage

From your photos it is difficult to determine if you had different size breasts to warrant using different size implants.  The after photo in the center suggests that the left implant is higher than the right.  This may be what is causing you increased cleavage on the left as you stated.  Perhaps, the left implant needs to be repositioned lower, but this would require an examination in person by a board certified plastic surgeon to make that determination.  

Todd C. Case, MD
Tucson Plastic Surgeon
4.9 out of 5 stars 55 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.