Breast augmentation is a plastic surgery procedure that either uses breast implants or your own body fat to add projection to the breasts, making them larger, perkier and shapelier. Women with smaller breasts use the surgery to accentuate their femininity. Also, if you have lost breast projection and volume as a result of weight loss, illness, medications, trauma or breastfeeding, you may qualify for the breast augmentation procedure.The surgery, not only increases the size and fullness of your breasts, it also enhances and balances your overall figure. It is a confidence booster and makes you feel good about yourself. Breast augmentation is also used for breast reconstruction after breast cancer treatments or breast injuries. Fat grafting for breast augmentation is generally considered a relatively safer method, and it delivers more natural results than breast implants.While the aesthetic results promised by breast augmentation via implants and fat grafting is impressive, there is never a guarantee that the results will be a hundred percent perfect. Breast augmentation doesn’t guarantee perfection, meaning to say, there may be times when it doesn’t turn out the way you expected it to. It bears pointing out that while breast augmentation is very safe, things can go wrong as a result of several factors like choosing an inexperienced and unskilled plastic surgeon, surgical errors, unrealistic and unreasonable goals and expectations, health problems, breast implant type and size, post-operative complications and poorly equipped surgical facility.One of the common problems many patients complain after the breast augmentation surgery is the asymmetrical or uneven nipples. After the breast augmentation surgery, your nipples may become asymmetrical, which is not quite pleasing to the eye.Uneven/asymmetrical nipplesThe breast augmentation surgery may lead to uneven nipples. There is also a probability that the areola may also be uneven along with the nipples. Uneven or asymmetrical nipples mean that one of your nipples is positioned differently than the other, or that your nipples point in unnaturally different directions.The different position of the nipples on the breast mounds is more common after breast augmentation. Preferably, the nipple-areolar compound should be positioned at a location in the breast that gives maximum, yet balanced projection. The bad news is that there is a probability that after the breast augmentation surgery, the position of the nipples may become highly uneven.Uneven nipples after breast augmentation occur as a result of a variety of factors.One of the major causes of uneven nipples after the surgery is the original position of the nipple-areolar compounds on the breasts. If your nipples were originally directed outwards, towards the cleavage, or downwards, and your plastic surgeon failed to take this factor into account when performing the breast augmentation surgery, there is a fair chance that your nipples will become uneven. Another surgery may be required to fix the condition.The size of the breast implant is another contributing factor that cause uneven or asymmetrical nipples after breast augmentation surgery. If you opt for breast implants, it is important for you and your surgeon to carefully select a breast implant that fits the dimensions of your chest wall. If your implant size is not proportional with your chest wall, the nipple-areolar compound will occupy an asymmetrical and unnatural place on your breast. This will make the nipples appear lopsided.The third factor that contributes to uneven nipples is the placement of implants in relation to the inframammary fold. If the surgeon is inexperienced or unskilled, he or she may position the implants too high, which will make the nipples point downwards. On the other hand, when the implant is positioned too low, the nipples will be directed upwards. Furthermore, if the implants were positioned far to the sides, the nipples will be directed to the center.Patients who experience these conditions experience extreme disappointment and emotional distress. A revision surgery may be used to fix the aesthetic imperfections introduced to the breasts by the breast augmentation surgery.Fixing uneven/asymmetrical nipplesYou should allow your breasts to settle for the first 3-6 months after the breast augmentation surgery. It is important to understand that the breasts need time to become soft, smooth and even after the surgery. If you detect uneven nipples right after your breast augmentation surgery, you should not rush to the doctor because it is too early.It takes your breasts approximately 3-6 months to show you the final results of the surgical intervention. If the uneven nipples fail to settle after the passage of 6 months, the patient may take up the problem with her plastic surgeon.In order to fix asymmetrical nipples permanently after breast augmentation, a surgical intervention is needed. The revision surgery is normally conducted under local anesthesia and takes around 40 to 50 minutes. The surgery is pretty simple and doesn’t require general anesthesia. Inflammation, and some degree of pain and discomfort are absolutely normal after the revision surgery.Depending on the type of nipple irregularity and cause of nipple asymmetry, your plastic surgeon may replace the breast implant with a different size implant or fix the nipple location, size and shape. If the nipple irregularity is mild, replacing the original implant with a differently sized implant is mostly the solution. There is also a probability that your surgeon would recommend you to undergo a mini breast lift in order to correct the breast asymmetry.ConclusionAsymmetry after breast augmentation is a common problem. Even though achieving perfectly even nipples is not always possible, taking measures to avoid uneven breasts after the breast augmentation procedure can ensure that your aesthetic goals are achieved to the maximum extent possible. Implant size, surgeon’s experience and skills or lack thereof, your current aesthetics and your aesthetic goals are some factors that lead to asymmetrical nipples.If your nipples have become uneven after the breast augmentation surgery, the condition can be easily corrected through a small revision surgery. However, it is important for you to select your plastic surgeon very carefully for that.