I'm 12 weeks post op breast lift and 600cc silicone implants. Why are my breasts so uneven? (photo)

I'm 12 weeks post op breast lift and 600cc silicone implants. Why are my breasts so uneven? Has one "bottomed out"??

Doctor Answers 8

Breast Asymmetry After Breast Augmentation/Lifting?

Thank you for the question and pictures.

It is difficult to give you good advice based on the pictures provided given that your arms are elevated. My best guess is that there is some degree of breast implant position asymmetry (possible bottomed out) causing the breasts to look different. Your plastic surgeon will be in the best position to advise you.

Continued follow-up with him/her.

Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,503 reviews

Breast asymmetry

Without an exam and looking at other views, there may be several reasons for the shape and look.  A vertical incision lift can give nice results.  Is your nipple sited too high? or are your implants too low?  Some asymmetry between volumes is fairly normal as no two breasts are the same. 

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

You have asymmetry because of bottoming out on one side, as well as the choice of technique.

Your surgeon has chose to use a vertical or "lollipop" type breast lift, which avoids the horizontal crease scar (or uses a "short" one) in an attempt to reshape the breast by taking skin out in one dimension and elevating the nipple. Unfortunately this leaves too much skin in the vertical dimension, where a horizontal excision will lift and reposition your crease closer to your nipple. (Another common downside to this technique is seen in the teardrop distortion of your areolas inferiorly.)

Your left breast (mirror photo) has bottomed out. Time will not make this better, but time will allow your next operation to correct the opposite breast if it too drops too low over time. Wait at least 3 months (6 is better) before considering re-operation. You should ask about a full Wise-pattern breast lift to correct the skin excess that the vertical lift did not address.

This isn't about "too-big" or "too-heavy" implants, it's about the skin tightening design. While vertical lifts can yield pleasing cosmetic results in SOME patients, it is clearly not for everyone! You unfortunately are one example of this. Perhaps plastic surgeons' zeal for "new" techniques make them apply these methods to too many patients in whom other "older" techniques might have been better. Or perhaps the marketing aspect of "fewer incisions and scars" induce both surgeons and patients to seek a one-operation-fits-all approach. Too bad!

For a patient of mine who had similar problems with a vertical lift plus implant on one side, and a different problem with a circumareolar (Benelli, donut, or periareolar) lift plus implant on the opposite breast resulting in 3 operations by 2 surgeons prior to my fixing her problem, click on the link below. Carefully consider your next step to avoid the problems this patient had. I'd advise additional opinions by experienced BPS-certified plastic surgeons who do lots of breast surgery. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Bottoming out is the reason for uneveness

From the photos provided, the right implant appears to have bottomed out.  The angle and shadows make an accurate assessment of the problem or problems difficult.  The large implant size is a contributing factor.  As has been discussed below, the weight of the implant is difficult to support with lax breast tissue and skin.

Go back to your surgeon and discuss options.  You may need to consider seriously using a smaller implant.

Michael S. Hopkins, MD (retired)
Albuquerque Plastic Surgeon
4.9 out of 5 stars 83 reviews

Challenges of breast lift and implants

Breast asymmetry that involves both volume and skin envelope differences can pose challenges, especially when adding a very full breast implant. The give in the skin can be less predictable, and the larger pocket size to accomodate the 600cc can be more difficult to control. We suggest a good support underwire and sufficient time to let everything settle in, and adjustment of the lift later can solve the issues.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

I'm 12 weeks post op breast lift and 600cc silicone implants. Why are my breasts so uneven?

The shadowed photos do not show a major size difference. But the shapes are different with right sided bottoming and to full inferiorly. Seek in person opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Bottomed out implants

In a patient who needs a lift, by definition, the skin elasticity is poor.  Putting in really big implants and asking the poor tissue to hold them up is asking a lot.  You appear to have bottomed out on your right side.  Please go back to your doctor and discuss this and what revision might be needed to fix this.  Maybe you need to go smaller to help hold the implants up better, at least don't think to go bigger.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Uneven breasts after breast augmentation

Your photographs show large implants with bottoming out and a vertical scar.  The implants appear to be in front of the muscle and 600 cc's are large implants.  The additional weight and weakened skin envelope from the vertical scar results in a typical bottoming out pattern.  You will need your implants removed, smaller implants placed retro-pectoral and at the same time your breast tissue should be elevated and the nipples elevated.  This can all be done through a circumareola incision to minimize additional scarring.  You are an excellent candidate for the Augmentation with Ultimate Lift.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 224 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.