A relatively common complication or consequence of breast implants placed for breast enhancement is when the breast implants settle in different positions or fail to settle to the proper position on the woman's chest. This type of asymmetry is usually very mild and does not require a second breast augmentation surgery. If this breast implant asymmetry occurs, it is usually undectable in bras, bathing suits or clothes. It is usually noticed when standing directly in front of a mirror and studying the breasts. The more concerning asymmetries may require a secondary plastic surgery. The type of secondary plastic surgery and its sophistication depends on the degree of breast mound asymmetry and its cause.

Upper pole fullness

If a breast implant failed to descend and has left the breast implant too high it can be the cause of excessive upper half fullness of the breast. This upper half breast fullness does not look natural. This 'upper pole' fullness can be treated by a relatively straight forward secondary plastic surgery. The breast implant on the high side is lowered by releasing the scar tissue capsule on that side. The scar capsule is released by cutting on the bottom half of the scar tissue capsule from the inside. So there is plastic surgery done only on the effected side. The weight of the implant will rest on the new lower position. Depending on how large the breast implant is or how much the breast implant has to be lowered determines how much scar tissue release is performed during the plastic surgery.

Lower pole fallout

A more difficult problem to correct after breast augmentation surgery for breast enhancement is when a breast implant settles too low. This may occur because of one or a few different reasons. Lower pole fallout may occur because of the weight of the implant, the quality of the woman's tissues, or because the pocket for the implant was made a bit too low. When the pocket is made a bit too low, the inframammary fold of the breast may have been stretched or released too much. When this support structure is over released the breast implant may be able to settle too low. When this occurs, it is has the opposite result of upper pole fullness and it is called 'lower pole fallout'. In order to correct this, a secondary breast implant plastic surgery is required. The breast's fold has to be reconstructed on the involved side. This woman will usually have to wear a support bra for a month of so to allow the fold to heal and reform.

Nipple misdirection

Another type of asymmetry involve the position of the nipple on the breast mound. Ideally, the nipple areolar complex should be near the most projecting point of the breast implant, and on the breast mound. A breast implant size should be selected to assure that this occurs. If a breast implant is malpositioned or the woman's breast skin and gland are large, the nipple may not be in a correct position. When the implant has settled in different positions on the different sides, the nipples may point in different directions. This can be disturbing to the woman and serve as an indication for a secondary plastic surgery even though the implant positions are only slightly different.

Usually a woman's nipples will be at different levels and as long as it is identified before the breast augmentation surgery, the woman is usually very pleased with her result because she has realistic expectations for her breast augmentation surgery.