Hello, and thank you for your question. There are several variables that go into planning and undertaking breast augmentation, which include the overall breast shape, the starting volume, the skin laxity, and the position of the nipple-areola. A lot depends upon your starting chest wall anatomy and breast template. When considering what implant to choose, there are more things that come into the picture. These include the width, the overall volume, and the shape of the implant. The projection and the width are important in that they need to match the base width of your breast and still provide the fullness that you wish to achieve. Another factor is the distance between the nipple-areolae (plural) themselves. From your pre-op photo, the nipple-areolae are slightly wide. The options would include a slightly wider implant that would reduce the gap - but because it needs to be centered on the nipple-areola - this would also increase the distance laterally. Another option would be to use techniques to center the nipple-areolae but these would require external scars as skin would have to be removed. In all fairness, given these details - and the devil is in the details - it looks like your plastic surgeon did a very nice job. Putting implants into a breast often magnifies the little imperfections. Lastly, it seems that you might speak with your plastic surgeon about releasing the left lower breast fold (the inframammary fold) to help the left implant drop into a more symmetric position. It would give you a chance to discuss whether to change the implant shape or to go larger. A board certified plastic surgeon will be able to identify your individual requirements and give you realistic expectations of what surgery can or cannot be achieved. I wish you the very best but you are definitely on the right track. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery
