Aligning asymmetrical breasts after breast augmentation surgery

Aligning asymmetrical breasts after breast augmentation surgery

09th Nov 2017

Even with breast augmentation surgery, there is still a risk of having asymmetrical breasts after the procedure. Although most asymmetries are not too noticeable, there are still some patients who may end up with highly noticeable ones.

The asymmetry of the breast after the augmentation can result from a false asymmetry, naturally asymmetric breasts, seroma, hematoma, and malrotation of the breast implants. Patients should choose their surgeons well, choose the size and shape of the implant properly, and conscientiously care for their breasts while healing to preclude aforementioned complications and asymmetry,

To correct the asymmetry, one can simply wait for the breasts to heal properly. In some cases, the temporary swelling or other short-term complications are the causes for the asymmetry. Revision surgery can also be done to correct the condition and the type of surgery depends on what needs to be corrected.

Asymmetrical Breast After Breast Augmentation

A breast augmentation surgery is meant to improve the appearance of the breast by making it bigger in size. Although most people who have the surgery are contented with the results, there are some who end up having asymmetrical breasts after surgery. If it is only minor asymmetry, some patients can live with it because it is quite common for women to have naturally asymmetrical breasts. Although not all women would notice the asymmetry, most do have a little of it. Having obvious asymmetrical breasts after surgery can be devastating though.

The Causes

Having asymmetrical breasts after breast augmentation surgery can be disappointing because, instead of improving, it could turn out much worse especially if the asymmetry is quite prominent and noticeable. To properly determine what steps to take to correct the asymmetry, it is best to identify the cause.

  • False Asymmetry: It is really exciting to see the results of a breast augmentation surgery. Some people are too excited; they forget that the final results won’t show up until after a few weeks or months after the surgery. This is because the breasts are still healing from the surgery and it is normal to find some swelling. The post-surgical swelling can make the breast seem asymmetrical because one breast may appear more swollen than the other. It is also possible that due to the swelling, the implants have not settled or dropped in its proper position yet. As the swelling dies down, the implants will also eventually settle. It may take upwards to 8 months before the implants settle down. For this reason, you may see some asymmetry within that time period.
  • Naturally Asymmetric Breast: Almost all women have some degree of asymmetry of their breast, and it is possible that it isn’t noticeable when the breast size is small. Due to the augmentation, it is possible for the breast asymmetry to become more obvious. Although some surgeons easily notice the asymmetry and may correct it by varying the size of the implants, some fail to do so and this could eventually lead to asymmetry.
  • Seroma: A seroma is a collection of fluid that builds up under the skin and it can happen after any plastic surgery like a breast augmentation surgery. A seroma can cause the asymmetry because of the varying amounts of fluid present. One of the breasts can have a seroma while the other doesn’t. The seroma usually goes away on its own but larger seromas need to be drained through drainage tubes or through a surgical needle and syringe.
  • Hematoma: Similar to a seroma is a hematoma, which is a collection of blood or a pool of blood around the breast implant. Like the seroma, the volume also varies and it will also resolve on its own. Those who take blood thinners are more prone to develop a hematoma after a surgical procedure.
  • Malrotation of Implants: There is a chance for the breast implants to rotate and for those who have rounded implants, this wouldn’t be a problem. On the other hand, those who have a teardrop or anatomical implants will clearly see the asymmetry once it rotates. If the malrotation is not immediately spotted, it can cause more severe problems because it will stretch the muscles on the upper part of the breast or the side where the implants rotated. Once stretched, it remains stretched and harder to correct.

How To Prevent Asymmetry

Most find beauty in symmetry that is why asymmetrical breast may appear unsightly to us all. In order to prevent asymmetry from happening after the breast augmentation surgery, here are a few things that should be done.

  • Careful Selection Of Surgeon: The best way to prevent having asymmetrical breast after the breast augmentation is to make sure you go to a reputable, board certified surgeon who has extensive experience. Breast augmentation may not be the same for all because women have different breast types. Some may already have asymmetrical breast to begin with and augmenting them will just make the symmetry more obvious. A well-experienced surgeon will know how to deal with asymmetrical breast and can do their best to correct the symmetry at the same time that the breast augmentation is being done. Well-experienced surgeons will also know how to do the surgery properly in order to lessen the risks of complications and unwanted results.
  • Proper Implant Size & Shape Selection: Sometimes, the asymmetry that would be observed is due to the position of the nipples and the areola. One factor that can cause this is the size of the implants. It is possible that the disproportionate size of the implants does not properly fit your chest wall. This will result in the unnatural positioning of the areola and nipples or asymmetry. It is therefore important, to choose implant sizes properly to lessen the risk of asymmetry. Round shape implants are also more favorable than teardrop shaped ones because even if they rotate, they won’t cause asymmetry of the breast.
  • Proper Care After Surgery: In order to prevent the asymmetry of the breast due to complications after surgery, observe proper post-surgical care for the breasts. It is important that patients strictly follow the guidelines provided by their surgeons to make sure that the surgery yields favorable results.

How To Correct Asymmetry

When the asymmetry is already there, there is nothing that can be done but to accept the asymmetry or look for ways to correct it. Sometimes, the asymmetry of the breast is due to the swelling after the surgery. The asymmetry at this stage is only temporary and will eventually even out when the breast has properly healed. Similarly, seroma or hematoma that can also form after the surgery can cause asymmetry but it can clear on its own leaving a more symmetrical breast.

If there is really asymmetry after the swelling is gone and the implants have settled, revision surgery is advised. The surgery that will be done will depend on the current state of the augmented breast. Among the common asymmetry issues are the following:

  • Unnatural Upper Fullness: If one of the breasts seems to be unnaturally full at the upper half portion, then it is possible that the implants did not settle properly or were pushed upwards. In order to remedy this, the surgeon will lower the tissue down so that the implants wouldn’t be pushed up and would settle at a lower position that is symmetrical to the other one.
  • Bottoming Out: It is also possible that the implant settles too low and causes your breast to look asymmetrical with the other. This can happen as a result of the heaviness of the implant, an error in the position of the pocket made, or the poor elasticity of the patient’s tissues. To correct this, it is possible for the surgeon to change the implant size if it is the main cause of the bottoming out. The inframammary fold will also be reconstructed so that it can support the breast implant in a higher position to match the other one. Additional support garments will also be used after the surgery to ensure that the repaired fold heals properly to support the implants.
  • Breast Implant Malrotation: The breast implants can rotate in the breast, which is why most patients have the rounded implants. Still, there are others who choose the teardrop implants. When this rotates, there can be asymmetry of the breast because the fullness can be found on the side or on top of the breast instead of the bottom. Sometimes, the implant can rotate back to the proper position but there are times that it doesn’t. Corrective surgery would recommend getting round implants instead of teardrop-shaped ones so that it wouldn’t cause any problem when it rotates again.


Most women have asymmetrical breast even if they aren’t really noticeable. Women who have undergone breast augmentation and have asymmetrical breast can be disappointed with the results. If the asymmetry is minimal, many choose to live with it. When asymmetry is too obvious that it affects self-esteem, then certain things need to be done.

The asymmetry of the breast after the augmentation surgery can be caused by different factors such as false asymmetry, natural asymmetry, seroma, hematoma, and malrotation of implants. To prevent asymmetry, patients should choose their surgeons well, decide on the proper size and shape of the implants and faithfully follow the guidelines after the surgery.

Some asymmetrical breasts can still even out when the breasts have completely healed. It is important to let the breast heal first before determining if there is really asymmetry. Properly healed breasts that are still highly asymmetrical can be corrected through revision surgery. The surgery that will be done depends on the asymmetry, but most experienced surgeons will know how to level or align the breast properly.

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