Asymmetry
Breasts are different in height, shape or volume; nipples look in different directions. Sometimes the difference between the breasts was there even before the operation.
CONDITION / BREAST
Unsuccessful breast augmentation.
Unsuccessful breast augmentation - when after surgery the breasts are different, a "double contour" appeared under them, waves or folds of the implant are visible through the skin, or the breasts change shape when the muscle is strained. Such defects are corrected by repeated surgery, usually when the tissues have healed and the result has stabilized.
CONCEPTUAL VISUALIZATION- What it is
- The result of breast augmentation is not as expected: asymmetry, "double contour", waves of the implant, change of shape during movement.
- How common
- In the registry of 5,373 women after cosmetic breast augmentation, asymmetry or displacement of the implant over 5 years was recorded in 5.2%.
- Repeat operations
- In post-registration studies by the FDA, 11.7% of women underwent reoperation after primary breast augmentation over 7 years.
- Who treats it
- A plastic surgeon who performs repeated breast surgeries.
01 / WHAT IS ITWhat do they think?
What do they think?
unsuccessful result.
Breast augmentation is an operation during which implants are placed in the breast: under the gland, i.e. above the pectoral muscle, or under the muscle. According to the NHS, this is a major operation and the outcome is not guaranteed.
The first weeks are not the result yet. According to the NHS, you can return to your normal activities after about 6 weeks, and a more natural look and feel to your breasts can be achieved in a few months.
The result is considered unsatisfactory when, even after that, the breasts are noticeably different, two folds are visible under the breast ("double contour"), waves or folds of the implant show through the skin, the breasts change shape when the muscle is strained, or the size is not what they wanted.
In a registry of 5,373 women after cosmetic breast augmentation, asymmetry or displacement of the implant was among the most common problems at 5 years — 5.2%, and the frequency of complications increased with years of follow-up.
Hardened breasts (capsular contracture), rupture, displacement or rotation of the implant are separate conditions, which have their own pages.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSMost often
Most often
does not suit
Complaints are often combined: for example, asymmetry and waves of the implant on one side.
"Double contour"
Two folds are visible under the breast, or the implant is separate from the gland, and the lower part of the breast seems to "flow" from it. In a series of 200 patients, such a change was found in 7%, it was pronounced in 0.5%.
Waves and folds
The waves of the edge of the implant can be felt or seen under the skin - when you lean forward or even while standing. Doctors call it rippling.
Movement during muscle tension
When you tighten the pectoral muscle, the breast changes shape and the implant moves up or to the side. This happens when the implant is under the muscle.
The implant is not in place
The implant has fallen below the fold under the breast, spread to the sides or shifted to the middle.
Rupture, displacement or rotation of the implantSize
Breasts seem too big or too small. In a study of 319 women, the desire to change the size or type of implant was the reason for 20% of repeat operations.
03 / REASONSWhy the result?
Why the result?
not like that
Part of the reason depends on what the breasts were like before the surgery, part on the implant and pocket for it, part on how the tissues change over the years.
Breasts before surgery
In a series of 200 patients, “double contour” was associated with preoperative breast droop, submuscular implant placement, and upward displacement of the implant, while unilateral was associated with preoperative breast asymmetry.
Thin fabrics
The waves are visible when the implant is covered with only a thin layer of tissue adhering to its surface.
Above or below the muscle
In the meta-analysis, contracture and hematoma under the muscle occurred less often, but displacement of the implant and change in shape when the muscle was strained were more common. Both options have their pros and cons.
Displacement of the implant
It is influenced by surgical technique, body structure, implant properties, capsular contracture, and age-related changes in the implant and breast.
Capsular contracture
The capsule around the implant tightens and the breast hardens and deforms. According to the FDA, this is the most common reason for repeat operations after breast augmentation.
Capsular contracturetime
Breasts continue to change around the implant. In the survey, among the most frequent reasons for reoperations are capsular contracture, displacement of the implant and sagging of the breast with age. According to the NHS, some women need another operation after about 10 years, either because of problems with the implants or because of these changes.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
If the operation was a long time ago and you are not satisfied with the appearance of the breast, this is a planned situation: it usually does not require emergency care. If the problem appeared in the first days or weeks after the operation, and there are no signs listed for 103, first contact the surgeon who operated on you.
103 immediately if:
- it became difficult to breathe or sudden shortness of breath appeared;
- sudden pain in the chest or upper back;
- the heart beats very often;
- the person fainted;
- heavy bleeding from the wound that does not stop;
- confusion or slurred speech;
- very frequent breathing;
- very high or very low temperature, chills or shivering;
- the skin on the body has become bluish, pale or spotted;
- a rash that does not go away when pressed.
When to the surgeon:
Immediately, at any hour: to the surgeon who operated, and if contact is not possible, to the reception department, if after the operation the breasts increase rapidly, become tense and painful, or the pain in the operated breasts is strong and increases. On the same day: to the surgeon who operated, or if this is not possible, to any surgeon, if the skin over the implant is reddened, hot or thinned, the implant is visible through it, liquid or pus flows from the wound, sutures have come apart, the temperature has risen to 38 °C or higher, or one leg hurts and is swollen. Coughing up blood is also a reason to see a doctor the same day. In the coming days: if a year or more after the operation, one breast suddenly increased or a new seal appeared, such late fluid around the implant must be examined. Planned: asymmetry, "double contour", waves and folds, movement of the breast during muscle tension, size - these are evaluated when the tissues have healed and the breast has acquired a more natural appearance, that is, after several months; you can see a doctor even earlier.
05 / DIAGNOSTICSAs defined,
As defined,
what to fix
- Conversation and documents
When and where the operation was performed, through which incision, above or below the muscle; passport of the implant (manufacturer, volume, shape, surface), statement and photo before the operation, if available.
- Overview in several positions
Standing, with raised arms, leaning forward and with a tense pectoral muscle - this is how you can see the waves, the "double contour" and the movement of the implant.
- Measurements and photos
The position of the nipples and folds under the breast, the thickness of the tissues above the implant, the difference between the two sides.
- ultrasound or MRI
Condition of the implant and capsule, is there any liquid around the implant; if necessary, the liquid is taken for analysis.
06 / TREATMENTHow to fix
How to fix
result
Tactics depend on what exactly is wrong, what the tissues are and how much time has passed. According to the review of repeated operations, for success it is necessary to simultaneously work with the implant, and with the capsule, and with one's own breast tissue.
01
First, wait
While the swelling passes.
- The first months
- According to the NHS, a more natural-looking breast can be achieved in a few months. It is too early to judge shape and symmetry.
- Acute problems
- Bleeding, infection, a gaping wound, or an implant protruding through the skin are treated immediately, not on a scheduled basis.
02
Position and form
Asymmetry, displacement, "double contour".
- Pocket and capsule
- The displaced implant is returned to its place: the capsule is sewn up, the implant is transferred to another pocket, matrices are used. Each case is planned separately, if necessary - in several stages.
- There is not much evidence yet
- In a review of 21 studies on implant displacement correction, all studies had a low level of evidence (IV–V).
- "Double contour"
- How to correct it depends on whether there were features in the tissues that predisposed to it. The options are another pocket, suturing the capsule, an implant of a different shape, matrices. In a series of 28 patients, it was smoothed with their own fat — in an average of 2.1 sessions; this is a small series.
03
Waves and folds
When there is not enough tissue above the implant.
- Why is it difficult?
- According to the NHS, implant waves are very difficult to treat.
- Options
- Traditionally, the implant is changed and often transferred under the muscle; a larger implant is also placed or a capsule is sutured. Recently, autologous fat and acellular dermal matrix are also being studied to thicken the coating.
- Matrices
- In a series of 197 repeat operations on the breast with a matrix (most often they were done due to contracture or displacement of the implant, due to waves - 4.8%) in 98% the complaint did not return; complications — in 4.8%. This is the experience of one center.
04
Movement during muscle tension and size
- Movement of the implant
- In a systematic review of 8 small studies (214 breasts, 63 of them after augmentation), the change in shape during muscle tension was corrected in all described cases, most often by transferring the implant over the muscle; complications after that were in 11.6%.
- Another size
- Implants are exchanged for others in terms of volume or shape; if they do not want to put them again, they are removed, if necessary, restoring the volume with their own fat.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
The unsatisfactory result of breast augmentation at Dr. Valikhnovskyi's Institute of Surgery is corrected in the direction of "Mammary gland reconstruction" - in particular, when the first operation was performed in another clinic.
CLINIC SERVICE
Breast reconstruction
Breasts after mastectomy - with own tissues, implants or fat, immediately or later.
View service
What we do for this condition
- Replacement of implants — implants are changed to others in terms of volume or shape or removed together with the capsule.
- Transfer to another pocket — the implant is moved under or over the muscle to change its position.
- Lipofilling — the patient's own fat is injected to smooth the contour and thicken the tissues above the implant.
- Dermal matrices and grids — biological matrices or synthetic meshes serve as a "hammock" or shell for the implant.
- Correction of the second breast — if necessary, the second breast is adjusted for symmetry.
- Excision of scars — a rough scar is cut out and stitched using a different technique.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the breast directly and from the side and, if available, the passport of the implant and a statement from the clinic where the operation was performed.
- ConsultationOverview in several positions, measurements; if necessary, ultrasound or MRI.
- PlanWhat exactly needs to be corrected, whether it is worth waiting, what techniques to combine and whether stages are needed.
- SurgeryReplacement of the implant, another pocket, matrix or lipofilling - depending on the reason.
- RecoverySupportive underwear and load restriction for several weeks; the doctor will tell you when to come for an examination.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
When can you do a repeat operation after breast augmentation?
If there are no acute problems, when the tissues have healed: according to the NHS, a more natural-looking breast can be achieved in a few months. When to operate on you, the doctor will tell after the examination.
Is it possible to be treated at your clinic if the augmentation was done in another clinic?
Yes. The doctor assesses what is now and makes a plan. Take the passport of the implant, the statement and the photo before the operation, if you have them.
How often is another surgery required after breast augmentation?
In post-registration studies by the FDA, 11.7% of women underwent reoperation after primary breast augmentation over 7 years. In a study of 319 women, the most common reasons were implant displacement (36.7%), capsular contracture (33.3%), and desire to change the size or type of implant (20%).
The waves of the implant are visible through the skin. Can this be fixed?
This is one of the most difficult problems: according to the NHS, waves are very difficult to treat. The coating of the implant is thickened with its own fat or matrix, the implant is changed or transferred under the muscle. The doctor will tell you what will suit you after the examination.
My breasts change shape when I tense the muscle. What to do?
This happens when the implant is under the muscle. In a systematic review, such a change was most often corrected by transferring the implant over the muscle; complications after that were in 11.6%.
Is it necessary to change implants after 10 years?
Implants don't last a lifetime and according to the NHS some women need another operation after about 10 years. Whether you need it and when, the doctor will tell you after the examination and examination.
Many years after the operation, one breast was enlarged. Is it dangerous?
Such a change should be investigated without delay: late fluid around the implant may be a sign of a rare lymphoma, almost always associated with textured implants. In a review of 95 patients, it appeared on average about 10 years after the operation. Diagnosis is made by ultrasound and fluid analysis.
Sources
18 sources · systematic reviews, meta-analyses, registries, research and NHSshowCollapse
- US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 PatientsAnnals of Surgery, 2019doi:10.1097/SLA.0000000000002990 ↗
- Local complications after cosmetic breast augmentation: results from the Danish Registry for Plastic Surgery of the breastPlastic and Reconstructive Surgery, 2009pubmed.ncbi.nlm.nih.gov/19730312 ↗
- Reoperation Rate After Primary Augmentation With Smooth, Textured, High Fill, Cohesive, Round Breast Implants (RANBI-I Study)Aesthetic Surgery Journal, 2019doi:10.1093/asj/sjy289 ↗
- Revision Breast AugmentationSeminars in Plastic Surgery, 2021doi:10.1055/s-0041-1727272 ↗
- Breast Implant Malposition: Prevention, Assessment, and TreatmentClinics in Plastic Surgery, 2026doi:10.1016/j.cps.2025.11.012 ↗
- Techniques to Repair Implant Malposition after Breast Augmentation: A ReviewAesthetic Surgery Journal, 2016doi:10.1093/asj/sjv261 ↗
- The double-bubble deformity: cause, prevention, and treatmentPlastic and Reconstructive Surgery, 2013doi:10.1097/01.prs.0000434405.91316.96 ↗
- Double breast contour in primary aesthetic breast augmentation: incidence, prevention and treatmentAnnals of Plastic Surgery, 2010doi:10.1097/SAP.0b013e3181b14284 ↗
- Management of a Common Breast Augmentation Complication: Treatment of the Double-Bubble Deformity With Fat GraftingAnnals of Plastic Surgery, 2016doi:10.1097/SAP.0000000000000553 ↗
- Rippling Following Breast Augmentation or Reconstruction: Aetiology, Emerging Treatment Options and a Novel Classification of SeverityAesthetic Plastic Surgery, 2018doi:10.1007/s00266-018-1117-y ↗
- Treatment of breast animation deformity: A systematic reviewJournal of Plastic, Reconstructive & Aesthetic Surgery, 2019doi:10.1016/j.bjps.2019.02.025 ↗
- Complications Following Subpectoral Versus Prepectoral Breast Augmentation: A Meta-analysisAesthetic Plastic Surgery, 2019doi:10.1007/s00266-019-01404-7 ↗
- Efficacy of acellular dermal matrices in revisionary aesthetic breast surgery: a 6-year experienceAesthetic Surgery Journal, 2013doi:10.1177/1090820X13478967 ↗
- Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic ReviewJAMA Surgery, 2017doi:10.1001/jamasurg.2017.4026 ↗
- Breast enlargement (implants)NHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/breast-enlargement ↗
- Pulmonary embolismNHS, 2026nhs.uk/conditions/pulmonary-embolism ↗
- DVT (deep vein thrombosis)NHS, 2026nhs.uk/conditions/deep-vein-thrombosis-dvt ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
The figures on the page are from these sources.
The result of breast augmentation
not satisfied?
Send a photo of the breast directly and from the side and, if available, the passport of the implant. The doctor will tell you what can be fixed and when.