What Went Wrong Here? Implants Too Low, Asymmetric Nipples and Excess Skin.

I had a breast augmentation done 5 months ago to get the fullness i lost from having children and breastfeeding. From day one I haven't been happy with the results but my PS kept telling me to give it time. Well I am completely healed and I feel they've settled completely but I HATE the way they look. They look way too low on my chest, one nipple i higher that the other and I have excess skin on my left breast. What went wrong here? My plastic surgeon seems to think everything is fine.

Doctor Answers 8

Asymmetric breasts after breast augmentation

It is impossible to fully answer your post because you did not post a frontal view of before surgery and the details of your surgery (implant position, surgical access etc.) are unknown. The photos show asymmetric breasts with the left nipple further from the midline and lower than the right, the left breast implant positioned further from the midline than the right implant and visible upper edges of both implants. On side view the left implant's center is above the level of the nipple.

You most likely had some asymmetry before surgery that was not recognized and became magnified by the placement of the implants. The optimal result is alignment of the nipples and upper notch of the breast bone in an equilateral triangle with 20cm sides and centering of the breast tissue and implants under the nipples in this position. It is not achievable in every patient given that some patients will be happier with less skin scar. To achieve your goals you will need redo surgery with adjustment of the current left implant pocket or a switch to submuscular pockets and some skin procedure to realign your nipple position.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Unhappy with appearance?

It's hard to completely answer your questions because the only pre-op photo you posted is the one from the side.  It's also hard to comment on your 'happiness' without understanding the conversations you had with your surgeon before hand.  From the pre-op photo it looks to me like you would have benefitted from a lift together with implants. I'm not sure if this was part of your pre-op discussion.  If you can describe what you don't like at this point then it would be easier to give you advice.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

You probably could have used a breast lift

Just looking at the side view of your left breast, but not seeing a frontal view or right sided view, I speculate that you have a moderate amount of drooping of your breasts from multiple pregnancies.  I think that you would have benefited from have a breast lift along with the breast augmentation.  The frontal view of you postoperative is fairly normal and probably as good a result as can be expected without a breast lift.

James Tang, MD
Houston Plastic Surgeon
3.4 out of 5 stars 18 reviews

Revisionary breast surgery

It also looks to me that you have implants placed over the muscle. I prefer placing implants under the muscle for the best long term results.  I would suggest that you discuss things in detail with your surgeon and see what his/her recommendation is for revisionary surgery to achieve your goals.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Sagging breasts

If your breasts were and sagging a bit before surgery and likely asymmetric, they will be after surgery unless a lift is performed in an attempt to balance them.

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

Unhappy at 5 months

my guess is that your expectations are different than your surgeons. i tell all patients" what you give me is what you get only bigger... unless we change the shape of your breast". you dont show a preop front view so i cant tell what you were starting with.  you can have secondary surgery at this point... go explain what you dont like.

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 64 reviews

Breast Augmentation

it is hard to tell from the photos, but you look like you have saline implants over the muscle. You are thin and did not have too much breast tissue to start. your breasts were ptotic or slightly droopy before the procedure.

options as I see it.

1-redo the procedure with submuscular silicone implants( if I was correct that you have saline over the muscle),with an uplift. That would give you a more natural appearance in my opinion.

2-do an uplift to even out the areolar positions and make them look less low on your chest. and leave the implants where they are. less cost, as implants stay, and are not changed.


Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 22 reviews

Breast Augmentation San Diego

Nothing "went wrong."  Regarding your nipple areola asymmetry, look closely at your pre-operative situation.  The nipple areola complexes were likely at slightly different levels.  Never expect perfection but improvement.  You said you wanted to restore the fullness you lost from having children and breast feeding.  Seems to me from the photos, this objective was soundly accomplished.  Your nipples are lateralized, and the surgeon could not change this.  I'm not surprised at the slightly wide intermammary distance, which is a result of your pre-surgical breast position.  There's also some infero-medial pectoralis major related asymmetry, not unusual and difficult to control and/or predict.

Breast implants are mechanical devices, not biological.  They are imperfect.  Asymmetry is normal.  The interaction between your body and the implants can be unpredictable.  In a bra, swimsuit, or clothing, the way 99% of the world sees you, your result is likely quite salutary.  In my opinion, your surgeon did a nice job.  Revision is of course, always an option, but proceed with caution, well defined goals, and a sound plan to achieve those goals.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 47 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.