Asymmetrical swelling after surgery

[imtakinemout]

Anybody had an asymmetric swelling and how long did it take for both sides to look fairly the same? Since day 1 I noticed the right side was bigger. It's been 5 wks now, and the right side is smaller, but not by much, and is still noticeably bigger than the left. It is tough to tell if it's swelling or excess fat that was not removed by liposuction. 
Surgeons are welcome to answer too in case they've seen this in their follow ups.
Thanks

[George Pope, M.D.]

Chest wall asymmetry after surgery is not common, but it can occur.  Sometimes more work is done on one side; sometimes one pec muscle is larger than the other.  I see this from time to time and the asymmetry usually resolves as swelling subsides.  Talk about this with your surgeon.  He or she may have expected this and may have a simple explanation. Best of luck.
Dr. Pope, MD

[imtakinemout]

Thanks Dr. Pope.
The right side was a little bigger before surgery, especially the inframammary crease was lower.
I am just surprised at how perfect the left side is after surgery- swelling almost gone, and the areola is flush with the rest of the skin. But the right side feels like there is some tissue in there and there is a visible side-boob. I hope it goes away.

[imtakinemout]

I have a couple of questions too:
1. The internal scarring. Is that supposed to go away in most cases? Or if it forms it is there to stay?
2. I'm wondering if the seemingly swollen side is not due to actual subcutaneous swelling but because of lax skin that hasn't contracted yet to adapt to the new contour. What do you think about that?

[George Pope, M.D.]

There is always internal scarring as the tissue heals.  Sometimes a lump or mass of scar tissue can form.  It usually responds to injection of a steroid medicine, but if not, it needs to be surgically removed if it's visible.
And laxed skin will not really make the chest look more swollen or puffy.  It is probably soft tissue (fat) that is still swollen, or possibly there's more tissue left on that side than on the other.
Dr. Pope, MD

[imtakinemout]

There is always internal scarring as the tissue heals.  Sometimes a lump or mass of scar tissue can form.  It usually responds to injection of a steroid medicine, but if not, it needs to be surgically removed if it's visible.
And laxed skin will not really make the chest look more swollen or puffy.  It is probably soft tissue (fat) that is still swollen, or possibly there's more tissue left on that side than on the other.
Dr. Pope, MD

Thanks Dr. Pope.

I would really be surprised if my surgeon has left that much tissue on one side. That brings up another question. How does the plastic surgeon assess the required quantity of fat to take out by liposuction? Is it a guess work?

I had the same distribution of bruising on both sides of my chest, so I am wondering how would the surgeon end up removing less fat on one side.

[George Pope, M.D.]

Amount of fat to be removed is based on appearance of the chest and amount of fat present.  Wouldn't call it guess work.  The bruising present postop has nothing to do with the amount of fat removed. It has to do with the number of tiny vessels that bleed from the trauma of the procedure.