American Society of Plastic Surgeons
For Medical Professionals
4 years ago

Best option for my breasts

I’ve had uneven breasts my entire life. I’m now 20 years old with a B cup and a C/D cup. They are also quite saggy and I assume this has to do with growing up overweight. My question is, in your experience what would be the best procedure for me as far as implants? I would like them to be full D’s.

Procedure: Breast Augmentation
Location: Los Alamitos, CA

Replies 8

Sandra Bouzaglou
ASPS Surgeon

You would best need a breast reduction on the right side and a lift on the left side. An implant for upper pole fullness will help as well as liposuction of the front bra rolls. I am happy to do a virtual consultation if you so desire for more details.

Farid Mozaffari
ASPS Surgeon

You have a significant breast asymmetry that can be improved, but it will be unlikely to get both breast to look exactly the same. I would recommend a lift with implant placement on the left side (augmentation mastopexy), and a lift or a lift with a reduction on the right side for better size matching.

Steven Wallach
ASPS Surgeon
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Sounds like you might need a combination of a lift abs implants and perhaps a small reduction of the larger breast. Best to be seen in person

Aaron Stone
ASPS Surgeon

2 stage surgery is best. 1st stage is mastopexies to decrease areola size, adjust creases (right side is higher than left) & change shape to more round to accommodate later implants (internal crescent mastopexy). 2nd stage would likely be lateral dual plane with reinforcement of the breasts creases to prevent downward movement of the implants & possible fat grafting. Implant size would be based on breast volume/dimensions at that time & what the tissues will hold. This will not work with very large implants & I doubt you tissues will hold a large D. 1 stage surgery risks skin necrosis from impaired blood supply and asymmetry.

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 in order to know if this assessment is valid.

Jon Sattler


You have a significant difference in your breasts. There are many ways to correct the differences. You will need a free in person consult. However, we can make some initial evaluations by way of Zoom, also free. Please contact my office manager to set up an appointment, (626) 852-0599.

Jon Sattler, MD

Christine Petti
ASPS Surgeon

Breast asymmetry of this degree will most likely involve at least a 2-stage procedure. There is significant atrophy of the upper pole breast parenchyma of both breast and severe relaxation and thinning of the overlying skin envelope. The right breast can be treated with a right breast mastopexy/slight reduction mammoplasty and placement of a small subglanduar breast implant with upper pole fullness such as an Allergan Natrelle, Inspira highly cohesive gummy bear silicone gel implant, The left breast can be treated with a left sub glandular augmentation mammoplasty and simultaneous mastopexy. The areola are very large and with the skin being so relaxed, the left breast and both areola may need additional surgery in the future to further achieve more symmetry . The patient may benefit from lateral chest bra fat liposuction and that fat and/or fat from other donor areas could be used to fat graft at the 2nd stage procedure. This situation is challenging, but is very possible.

Nelson Castillo

Thank you for sharing your question and photographs. The best initial approach would be a lift on the smaller breast side and a lift/reduction on the larger breast side. Whether you decide to have implants is based on the appearance you are attempting to achieve. Best wishes.

Robert Freund
ASPS Surgeon

To improve the saggy breast, you would need a lift. The lift can be combined with assymetrical implants to compensate for the difference in size or alternatively, the right breast can be reduced in volume and equal size implants placed to attempt symmetry.

In any case, your breast will likely never be perfectly symmetrical, but can be close!


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