4 Weeks Post-op - Uneven Breasts?

4 weeks ago I had smooth saline implants (325 cc.) placed under the muscle. I was told at my 1st week appt. that one implant had "dropped" but not the other one. The breast with the implant that "dropped" (left) looks bigger/fuller than the other, and the nipple is at a lower position. I understand I may have to wait months to see the implant "drop", but would the (right) breast look bigger/fuller like the other one once the implant drops? I am worried because I do not think that's the case.

Doctor Answers 26

Breasts are Asymmetric After Implant Surgery.

You most likely had asymmetry in your breasts before surgery. It is quite common. However, even small asymmetries can become amplified after breast augmentation. At 4 weeks you are still in the early phase of healing and I recommend waiting around six months to let everything settle down.


Dr. Babak Dadvand

Los Angeles Plastic Surgeon
5.0 out of 5 stars 29 reviews

It takes patience to see breast augmentation results

Patience is one of the most important factors in achieving the best results in cosmetic surgery. We all want to see the final result as early as possible. Unfortunately, the healing process is complicated and takes time. You cannot fight Mother Nature. The surest way to get a poor result is to undergo revision surgery before your body is ready for additional surgery.

With more than 30 years and thousands of breast augmentations, I have found that breast augmentations take about six months for the swelling to go down and the breasts to settle and assume their final size and shape. When we do a breast enlargement, surgeons try to center the implant behind the nipple. Minor position adjustments can be accomplished to account for the normal asymmetry that most women have. If the breasts are different sizes, saline implants can be adjusted to achieve better symmetry.

A set of preoperative photos would help in assessing your degree of asymmetry in breast size and nipple position.

Please wait until six months post op and then return to your original surgeon. Minor asymmetry is normal. Too vigorous surgical approaches may result in more expense, more scarring, and new complications.

Be patient and realistic.

Richard L. Dolsky MD

Richard L. Dolsky, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 4 reviews

Post-op augmentation

The two breasts look pretty good. I owuld just leave them alone and let them heal.  Remember we all have asymmetry.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 22 reviews

Breast implant healing

At this point you just need to wait.  There is no obvious problem here so let the full healing take place over 6 months.

Asymmetry at 4 weeks after breast implants

At 4 weeks, some swelling and tissue tightness is still expected.  It's really "too early to tell" in terms of subtle shape differences.  Give it 2-3 months before judging the final result.  

Also, posting a "before" picture would be helpful - many people have pre-existing asymmetries that they don't even notice beforehand...but they sure notice them afterwards!

Your surgeon can best advise you on this.

All the best,

Breast implant results can be seen after 3-4 months.

You should be patient until 3-4 months after surgery.  Make sure you are following all of your post op instructions and doing any massaging as directed by your surgeon. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Wait a little longer

Your breast will drop at different rates and for them to be in different positions at 4 weeks is ok.  It will take about 3 months until they look great!  You probably didn't notice the asymmetry in position of the nipples or the folds underneath your breasts before surgery but those things are most likely the same now too.

Breast asymmetry

It is interesting to me to see how critically pin point accurate patients are to see a tiny bit of symmetry after surgery but noticed nothing after 20 some years of having asymmetrical breasts and never noticed a thing. . We get photos of every single patient to show the patient PRIOR to surgery what to expect AFTER her breast aug so that she knows that the aug will NOT be perfectly identical and that's when they realize that they were not built perfectly identical.  Once we discuss this with our patients we don't see the problem.  Interesting how it works but clearly it's a psychological thing.  It reminds me of how much of a doctor we all need to be throughout all of this.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 100 reviews

Breast asymmetry after augmentation

When we look very carefully at pictures before and after breast augmentation, asymmetry in the shape of the breast envelope, and nipple position are common and the implants can call attention to what was there all along. I'll bet that your right breast was slightly larger, the nipple slightly larger, and the skin fuller nipple to natural breast fold. It is true that after six months things can improve a bit and it is too soon to panic. We can all see what you do, though at this time massage gently, resume some exercise, and wait and see.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 38 reviews

Uneven breasts after augmentation surgery

In the photos, it is obvious that the right breast appears larger, and the nipple areola sits lower on your breast on the rigth.  But because you dont post before pictures, it is hard to determine why you have the asymmetry.  I doubt that the asymmetry of the nipple position will change much unless you do something about it.  I will typically place my patients in a breast strap or bandeau putting pressure over the breast that the nipple looks lower on.  This helps to strech the capsule around the implant and allow the implant to "settle" more, which in turn will help to elevate the position of the nipple.  This is usually done early after surgery or as soon as the asymmetry is seen.  But the volume asymmetry is another situation.  Was the volume the same before surgery?  If so, then you may have swelling still on the right, or you could have fluid around the implant.  Without a more detailed history, it is difficult to speculate the reasons.  You should see your surgeon to discuss your issues and determine what the best plan of action is.

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 102 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.