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Breast Augmentation Redo to Bring Breasts Closer Together?

asked 2 years ago by jkimmel in california
Latest answer by Brooke R. Seckel, MD
Question viewed 3,105 times
Tags: saline implants, under muscle, 5 years post-op, 300-349cc, cleavage, gap

Hello. I had a Breast Augmentation 5 years ago they are 300cc mentor round saline implants that are under the muscle. They are very far apart and flatten out when my arms flex.

I would like to get them redone so I can have some cleavage. Is this possible because my areolas are very far apart naturally and I have a very round ribcage. I want a wider closer together breast without have a lot of projection Is this all posible?

18 answers to Breast Augmentation Redo to Bring Breasts Closer Together?

Revision of Breast Implants to Bring Closer Together for Better Cleavage

Thank you for your question. Yes revision can be done to bring your breast implants closer together to improve your cleavage. You will need a capsulorraphy or "Internal Ryan Procedure" to close down the lateral or side area of your breast implant pocket. Your implants are displaced to the side because the pocket is too large and too far off to the side. The excess pocket can be closed with sutures. The medial pocket -near the breast bone can be enlarged to allow the new... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

Breast Augmentation Redo to Bring Breasts Closer Together?

Looks like yo have done your homework ! You are right, when your chest anatomy is rounded or has a pectus carinatum (pigeon chest) appearance it does tend to place the breast and the nipple areolar complex more lateral. That will separate breast apart and decrease the "cleavage". Breast implants of the right size, width and projection can improve this problem to a certain degree in an unaugmented patient. It is important to choose the right implant for the right patient. Thin patient's... more

Tal T. Roudner, MD
Coral Gables Plastic Surgeon

Wide space

You naturally have a large separation between your breast. This has been exagerated by the lateral displacement your implants experience from the pectoralis action. This can certainly be improved surgically by a combination of using a better choice of implants (Larger, less profile) and capsular correction (closing the lateral expansion of the capsule and probably releasing the capsule medially) Even though the appearance will improve there will still be a fair amount... more

Juan A. Brou, MD
Oklahoma City Plastic Surgeon

Breast implant revision

Much of the final “look” achieved after breast augmentation revision surgery depends on several factors: 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal. 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Breasts and cleavage

Cleavage is sometimes hard to give to patients that anatomically did not have it before. You can cheat it a bit by using wider implants, and making sure that the implants are not falling off to the sides by tightening the lateral capsules.

Steven Wallach, MD
Manhattan Plastic Surgeon

You need revisionary surgery

Breast implants are wonderful, but there are times when surgery revision is appropriate and necessary to achieve a more beautiful and natural result. In your case the implants are farther apart than they should be. You need a wider implant that will fit the width of your chest wall and overall be more appropriate for you than the original size that was picked. Sometimes with the high profile implants, they are quite narrow and really only good for patients that have... more

Kimberly A. Henry, MD
Greenbrae Plastic Surgeon

The Great Divide in Breast Augmentation

Ms. JKimmel, Sometimes women can have reshaping of the internal aspects of the pocket (capsule) and/ or a wider implant can be used. What is important is to try to place the implant so that the nipple-areolar complex is centered on the implant. If you have widely spaced nipple-areoar complexes due to a rounded chest shape it would throw off the relationship between the implant and the nipple-areolar complex if the implants are placed closer together. It may not be possible to increase the... more

Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon

Breast Revision Surgery

You can definitely have an improvement. However, one needs to be careful not to over do it as you have mentioned is that your nipples are far apart. The key is to center the implant just under your nipple and areola complex. So yes the implants need to be moved over a bit by a capsulorrhaphy and center under your NAC, but they will still be some what far, closer than they are now and better looking but still you will not have a lot of cleavage, and that is secondary to your anatomy... more

Farbod Esmailian, MD
Orange County Plastic Surgeon

Revision breast augmentation can help with cleavage

I feel breast augmentation revision would be beneficial to help improve your cleavage and recenter your nipples. It appears the pocket that was created under your muscle from your first surgery may have been to large allowing your implants to migrate laterally. As a result, your nipples are not centered on your breast mound and you have lost whatever cleavage you may have had prior to surgery. In an attempt to correct this problem, I feel you may benefit from either changing the location... more

David A. Robinson, MD
Munster Plastic Surgeon

Is improvement in my Breast Implant Result possible?

Hi there- There is no question that your result could be improved. I would visit with a few Board Certified Plastic Surgeons, discuss your goals, review photos of their work in situations like yours, listen to their plan to correct this problem for you, and decide based on your understanding of their ability to achieve your goals. I am not a believer that your nipple position would limit your outcome, but do agree with Dr. Rand that form the photo you posted it looks like you need... more

Armando Soto, MD
Orlando Plastic Surgeon

Lateral drift of breast implants

Your breast implants are have definately drifted laterally. This can be due to several factors. In general the weak spot, when implants are placed under the muscle, is the lower outer quadrant. Time, weight, gravity and the constant action of the muscle can force the implant in that direction. Obviously your breast implant pocket is too small and you may need an implant with a larger base. The slope of your chest wall also contributes to this deformity. A revision of your augmentation... more

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Breast augmentation revision for wide breasts and cleavage

As Dr. Aldea and Rand have stated, you can obtain an improvement. I have also found that many patients develop this appearance after pectoralis strengthening exercises that displace the implants to the outside of the chest. following repair I frequently advise patients to avoid these activities such as wide stance push ups, bench press, and butterflies or the "pec deck." In the past, textured implants were used to keep the implants in place but these are not popular in the US.... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Revision breast augmentation for muscular distortion

Submuscular breast augmentation does have the advantage of better cover to hide a breast implant, especially when the breast tissue is thin, and does reduce capsular contraction. Sometimes though the trade-off of augmentation under the muscle is defection and distortion of the implant as the chest muscle is contracted. As your photo demonstrated, the implants are pushed out to the side of the chest and do appear to flatten. The effect is not attractive and you may do better with revision of... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Revision breast augmentation is in order and should give you a much better result

Your breast augmentation pocket Is way to big and way to lateral. As you can see your nipple areolar complex is very medial. I feel that the best way to redo your breast would be to replace your implants with textured Silicone gel high profile implants. you will need to have the pocket opened medially and the pocket closed laterally. If you have enough natural breast tissue then I would place the implants under your breast in an entirely new location. If your native breast tissue is to... more

Carl W. "Rick" Lentz III, MD
Daytona Beach Plastic Surgeon

Breast augmentation re-do

Your result is obviously suboptimal. You need a much wider implant and you need the pocket dissected more medially and the lateral pocket excess repaired. One challenge you face is that your chest wall angles steeply laterally away from the midline and this makes it hard to get cleavage. You need a very experienced plastic surgeon to handle your not so easy re-do.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

www.randcosmeticsurgery.com

Breast Augmentation redo for cleavage

Yes you need a revision surgery via open capsulotomy - medial chest area. This will allow the 'cleavage' you desire. But your nipple/areloar are very far apart, so I think it is your anatomy that is an issue also. Regards.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Getting More Cleavage in a Re-Do

Breast Augmentation surgery, in a way, is similar to Golf and to Poker in that - the surgeon has to "play" the ball where it lands or the cards dealt to him/her - but unlike these games, we do not get a do-over or a Mulligan. To look normal, the nipple/areolas MUST be at the center of the implants NOT falling along one of its slopes. If the areolas are to the sides, the implants must be there as well. The ONLY solution in your case is to use wider based implants which would... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Natural variation in breasts

While surgery can modify your breasts, natural variations may limit what can be done. Certainly your widely space nipples do not allow implants to be place too close together since this would put the nipples at the wrong position on the breast mound. You might be able to move the nipples slightly closer together but this would necessitate scars around the areola. Implants under the muscle limit the cleavage so you might consider going on top of the muscle and use the lowest profile silicone... more