In short. The simplest plan for asymmetry, and the one most likely to disappoint when the difference is shape or fold position rather than volume.

Key points

  • Stand in front of a mirror and find the crease under each breast.
  • If the two creases are at the same level, and the two nipples are at the same level above them, the difference is probably volume.
  • If one crease sits lower than the other, the difference includes position, and adding volume to the smaller side will make that breast larger without making the pair look alike.

Adding volume to the smaller breast is the simplest plan in this area of surgery, and for the right finding it is also the best one. It treats one side, leaves the other untouched, and keeps the operation and the recovery shorter than any plan that operates on both.

What it fixes

Volume. Where one breast holds less tissue than the other and everything else is symmetrical, adding volume to the smaller side balances the pair. The two folds sit at the same height, the two nipples are at the same level, the bases are of similar width, and the whole difference is one of how much tissue is there. Under those findings the plan is short and it works.

Check the fold height before you assume it is volume

Stand in front of a mirror and find the crease under each breast. If the two creases are at the same level, and the two nipples are at the same level above them, the difference is probably volume. If one crease sits lower than the other, the difference includes position, and adding volume to the smaller side will make that breast larger without making the pair look alike. The crease is the finding most often missed.

What it leaves

Everything that is not volume. A fold that sits lower on one side is not raised by adding tissue above it. A nipple at a different height is not moved by an implant or by transferred tissue. A base that is wider on one side stays wider. And a difference in shape, where one breast is more conical and the other more rounded, persists, because a larger cone is still a cone.

Why this is the commonest disappointment

Because volume is the easiest difference to see and the easiest to describe, and a patient who arrives describing a size difference may not have noticed the fold or the nipple height. The operation then corrects what was described and leaves what was actually producing the imbalance. That is not a failure of the operation. It is a plan written from the wrong finding, and it is avoidable by measuring before deciding.

Findings that mean one side is not enough

  • The crease under one breast sits lower than the crease under the other.
  • The two nipples are at different heights, or one points in a different direction.
  • The base of one breast is noticeably wider across the chest wall than the other.

None of this makes a single-sided augmentation a poor operation. It makes it a specific one, and a patient whose difference is genuinely volume will do well with it and better than with a longer plan.

Related reading

Frequently asked questions

When is treating one side the right plan?

When the difference is genuinely one of volume: the two folds sit at the same height, the two nipples are at the same level, the two bases are of similar width, and one breast simply holds less tissue than the other. Under those findings, adding volume to the smaller side balances the pair, and the operation stays as short as a single-sided procedure can be.

What does it not correct?

Anything that is not volume. A fold that sits lower on one side stays lower. A nipple at a different height stays at a different height. A wider base stays wider. And a difference in shape, where one breast is more conical and the other more rounded, is not corrected by making one of them larger. Those findings need a different operation, or an additional one.

Will the two sides match afterwards?

They will be closer in volume and they will not be identical. The two sides swell at different rates and settle on different schedules, and the added volume integrates over months. A small residual difference is the expected outcome, which is the honest target of any asymmetry plan rather than a shortfall of this one.

Risks & Limitations

  • No operation produces a matched pair. The two sides start differently and heal on different schedules, so a small residual difference in size, shape or position is the expected outcome rather than a complication.
  • The recovery is that of the larger of the two operations in the plan, not an average. A lift carries scars that an augmentation does not, and a longer period for those scars to mature.
  • Where the difference is partly in the chest wall, that part cannot be corrected from the breast and will remain after the operation.
  • Scars are permanent, and a plan that treats the two sides differently leaves scars of two different kinds.
  • A difference that is new, changing, or accompanied by a lump, skin change or nipple discharge is assessed as a diagnostic question before any surgical planning.
  • Changes in nipple or skin sensation may occur, are often temporary, and may be lasting. Where an implant is used, its own long-term considerations apply.

When to Seek Care

  • A new lump, a change in the skin over either breast, discharge from the nipple, or a change in the nipple itself &mdash — have it assessed promptly rather than waiting for a cosmetic appointment.
  • Fever, spreading redness, warmth or discharge from a wound, or a wound that is opening.
  • A breast that becomes hard, swollen, painful or red around an implant &mdash — contact the team the same day.
  • Calf pain, swelling or tenderness in one leg, or shortness of breath or chest pain &mdash — seek emergency care at once.
  • Chest pain, breathlessness or a racing heartbeat after surgery &mdash — seek emergency care at once.

References & Further Reading

  • American Society of Plastic Surgeons (ASPS) - breast surgery and patient safety guidance
  • National Institute for Health and Care Excellence (NICE, UK) - guidance on breast surgery and on venous thromboembolism prevention
  • Cochrane Library - systematic reviews in breast surgery and wound care
  • British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) - patient information on breast surgery
  • Chinese Medical Association Plastic Surgery Branch - clinical guidance

Medically reviewed by Tongchun Mao, MD (毛彤春), Deputy Director & Head of Aesthetic Surgery. Last reviewed: 19 September 2026.

This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.