Hi @DaytonTN,
Your mesh appears to not be symmetrical in the ZBrush worldspace.
Turn on the Floor Plane with all 3 axes enabled. Go to the draw palette and make sure the “Elevation” slider is set to zero. Turn off perspective mode. Make sure local symmetry (L.SYm) is Off.
This will let you preview the symmetry planes. If your mesh is not the same on both sides of each of those axes, then your mesh is not globally symmetrical in the worldspace along those axes, and global symmetry operations won’t function correctly. The most common reason for this is a mesh that has become offset from the center for one reason or another.
Now, if you enable Local Symmetry (L.SYM), symmetry operations will use the mesh’s own center for symmetry. If it still isn’t working, it means your mesh’s bounding box is not the same on both sides, either from geometry that is not the same on both sides of the bounding box center, or maybe from a piece of geometry that is present on one side but not the other, pushing the bounding box out of whack on one side.
You can repair this by forcing your mesh back into symmetry. The Tool> Geometry> Modify Topology> Mirror and Weld function can be used to do this. It will force the mesh back into symmetry across the tool center (or across the local center of the subtool if L.Sym is enabled. You will first need to make sure that the intended center of the mesh is as close as possible to the center of the symmetry operation.
Keep in mind that Mirror and Weld only works in one direction, so in certain situations it may first be necessary to flip the geometry to the other side of the axis first with the Tool> Deformation> Mirror function along the relevant axis to make sure the correct side is mirrored.