Breast Augmentation: Q&A

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How Do I Avoid Getting a "Refund Gap"?

I am scheduled for a breast augmentation on the 20th of this month with Dr.Guerra in Scottsdale,Az. Iv been wanting am augmentation for years but my biggest concern is ending up with a "refund gap" you know, the abnormal amount of space between breasts. What causes this?! How can i explain my concern to my doctor? Im 5"2 and 110 lbs, currently a 32B, looking to go to a 32DD. Thank you.

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17 Doctor Answers | Asked by Miladoll in Scottsdale,Az

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How Do I Avoid Getting a "Refund Gap"?

I have never heard that expression before! It describes the wide space between the breasts. When you see this in post-op photos, the commonest cause is pre-op anatomy. When patients breasts are far apart before surgery, they will be far apart after surgery. The implants are centered according to breast location. If they are placed more centrally than is the breast, the nipple and areola will be on the side of the breast, a finding that is quite bizarre looking, and certainly less attractive... more

Increasing cleavage

The abnormal wide space between the two breasts can be reduced transposing the breast tissue medially. This can be done through a circumareola approach. There is a new technique called The Mini Ultimate Breast Lift and can be used simultaneously with a breast augmentation. When placing implants retro-pectoral, it may be difficult to go from a 32 B to a 32 DD. Best Wishes, Gary Horndeski, M.D.

Gap Between Breasts?#breastimplants

Miladoll, thanks for the question. I feel that good communication with your surgeon is always very important. I tell my patients that most of your cleavage is determined by your anatomy. The pectoralis muscle attaches to the breast bones on either side at defined positions. This will largely set the tone for what kind of cleavage you will or can have. The other aspects are the profile of the implant and the dissection of the pocket. Communication is key with your surgeon and spending the... more

A wide breast bone causes a wide gap between the breasts

Thank you for your question. The main determining factor for having a wide separation between the breasts is a wide breast bone. Trying to narrow that distance by putting the implants closer together makes the breasts look abnormal and increases the risk of rippling in that area.

You body shape will dictate the gap

You have chosen a great surgeon and he can answer your questions after examinations. The gap depends on the anatomy and implant position.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Avoidance of "Refund Gap" Post Augmentation

The term "Refund Gap" is not one that I have heard before, but you indicate that it refers to abnormally wide space between the breasts. Everyones breast/chest anatomy is different, and some individuals have a wide space between their breasts before augmentation. While breast implants do improve cleavage, their are limitations (based on your anatomy) to how far the cleavage can be enhanced. If, in an attempt to create more cleavage, a surgeon uses an overly large or wide implant, or... more

The refund gap

We're all lifetime learners and now we've learned something new---I had never heard of this phrase and thought it referred to a cancellation penalty. The gap is based on your own anatomy and the distance between the breasts. Implant selection can be a factor and going from a B to DD, if you do have a gap to begin with, will highlight the gap even more. Discuss the sizing and your concerns with your plastic surgeon in person.

Gap between your breasts

Though the prvious posts present very detailed explanations, the simplest way to look at this issue is by looking at the width of your chest, the distance between your nipples, and the shape and size of the implant you choose. You have to center the implant under your nipples. If your nipples are widely spaced apart, you will have a gap between your breasts unless you use a wide or large implant. However, this can also create too much breast on the side of your chest (side... more

Tell your surgeon you want as narrow cleavage as is safe and anatomically possible!

"Refund gap" is a new one for me, but refers to excessively-wide cleavage. At your petite size and with your large-breast goal, your surgeon should have minimal difficulty helping you achieve your narrow cleavage look--with some anatomic limitations. If your surgeon creates pockets that are excessively "close" in the mid line in an effort to achieve that "narrow cleavage" you seek, you could end up with symmastia (uni-boob), which is more common with large implants already. This requires... more

The refund gap after breast augmentation

We actually have never heard this term before in reference to the space between the breasts after augmentation. The distance between your breasts is determined by anatomy, and during augmentation the implant must be centered under the nipple for the best marriage of breast and implant. Certain implants can accentuate the gap, those with a narrow base and a higher profile. A broader base will distribute the volume more effectively into the mid chest. Photos of what you wish to look like will... more

Wide Gap Between Breast Implants

Assuming the surgeon is placing the implants behind the pectoralis muscles, the location of muscle attachments to the breast bone will be a big determining factor as to the width of that space. Surgeons understand the patient does not want a wide gap and do everything they can in keeping with your anatomy to prevent that. But if they release those tissues more than appropriate, the skin may lift up over the breast bone so there is no cleavage.

Optimizing the intermammary distance

The space between your breasts (intermammary distance) can be somewhat controlled by the type of implant that is used. In some cases, using a lower profile implant or one with a wide base width can help minimize this gap. However, there are certainly limitations in how close a surgeon can minimize this gap. Your chest wall anatomy will in large part dictate how close the implants appear after surgery. There are several things to be careful of when trying to narrow this space. If the natural... more

Avoiding gap between breasts

The gap that occurs between the breast can be a function of your breast bone/chest wall anatomy, or the implant size chosen. Generally a larger implant will fill the gap, a smaller one will not. Otherwise, the breast bone anatomy is not something that can be changed by breast augmentation surgery. Please explain your concerns to Dr. Guerra. I trained with this doctor and can attest to his expertise and attention to detail. You are in wonderful... more

Avoidance of “Refund Gap” during Breast Augmentation?

Thank you for the question. It will be important to communicate your goals with your plastic surgeon carefully. In my practice, I find that this communication is enhanced with the use of goal pictures. Show your plastic surgeon examples of cleavage areas that you like versus those of what you do not like. Keep in mind, that the space between the breasts will largely be determined by your own anatomy. Other factors that will come into play will be the pocket dissected for the breast... more

Gap between breasts

The gap between breasts is determined by the width of your sternum (breast plate). If you have a wide sternum, the gap between the breasts will be wide; if the sternum is narrow, the gap will be narrow as well. As any surgery, you need to share your concern with your plastic surgeon. Please ask him whether you have a wide sternum or not. Breast augmentation is meant to enhance what you currently have; what you will look like post-op is determined by how you look... more

Wide space between breasts

If you are referring to excessively wide space between your breasts (ie cleavage distance), then this can manifest for several reasons which include but are not limited to: surgical technique (under dissection of the medial breast pocket), implant selection (implant does not provide enough width for your chest wall), and your anatomy (some women are born with a wide sternal bone and there is no surgery that can safely compensate for that). So please express your concerns to your PS.... more

A Refund Gap?

Your question has been more than adequately answered by the experts here. The question you will have to answer for all of us is "Where did you hear of the term Refund Gap?"