5-6 Inch Gap Between Natural Breasts- What Can Be Done? (photo)

Thank you for your question. You would actually be a good candidate for a mastopexy (breast lift surgery). On its own, a breast lift does not anatomically decrease the distance between the breasts, but it changes their shape significantly, making said distance less noticeable. If you wish to have larger breasts, you could undergo an aug/pexy, which is a breast augmentation with implants performed at the same time as a mastopexy. In terms of selecting a breast implant profile, the profile does not really affect the cleavage width.

Cleavage is one of the characteristics that’s associated
with physically attractive breasts.For
this reason, it’s not unusual for patients to desire this anatomic
feature.Unfortunately, this isn’t
always possible because of specific anatomic restraints that they may have. Your
pictures suggest several areas of concern.These include significant breast sag, a lateral sloping chest wall, a
mild tubular breast deformity and lateral displacement of your breast tissue.Although
you would benefit from submuscular breast augmentation and bilateral breast
lift surgery, this might not entirely accomplish your aesthetic goals.It’s
important to realize that breast implants need to be centered beneath the
nipple areola complex to avoid secondary distortion.When the nipple areola is displaced laterally,
it can only be moved so far inward during a breast lift procedure without
adversely impacting breast aesthetics.It’s also important to realize that underlying chest wall abnormalities
can impose limitations on your final result as well. Under
these circumstances, breast augmentation performed in combination with breast
lift surgery would be expected to significantly improve breast aesthetics.Unfortunately, the amount of cleavage would
be limited by the lateral position of the breasts and the shape of the
underlying chest wall.

Thank you for your question and the photos. I see the truth in other comments and will mention another possibility for you to think about options.  One possibility may be to perform breast lift supplemented with some modest fat grafting around the perimeter of the breast.  You are only 20 years old and your breasts are going to change as you age, especially if and when you have children. If you get implants now, you will almost with certainty need revisions or redo in the future.  Also, at your age, wide heavy implants will pull on your tissues and thin them out over time. This could make revisions problematic in the future.  If you get a breast lift with modest fat grafting now, you may be able to postpone surgery with implants to a later time.  Just a thought. To be sure you qualify for something like this, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  See a surgeon who is experienced in fat transfer.  I hope this helps.

Your posted photos show narrow based cylinder shaped breasts with a wide separation between them i.e. there is no cleavage. Unfortunately no matter what anybody tells no current surgical technique including implants or breast lifting can create cleavage. My breast surgery consents specifically state this.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

1. Wide implants, 2. Submuscular positioning, 3. Areolar approach for placement, 4. Areolar lift with purse string closure for reduction of areola size and tightening of skin envelope, 5. Radial scoring of mammary parenchyma (breast gland) for even distribution of this constricted tissue across implant surface to better camouflage implant-tissue interface, 6. Post surgical support bra. 

correction of tuberous breasts:


you will need a lift  of some sort

periareola may be sufficient

and implant of low or moderate profile will help shape the breast

consideration will include whether over or under the muscle will be best 

I would first make sure your expectations for a surgica result are in line with what is possible for a patient with your tuberous and widely spaced breast anatomy. Personally, I would offer a breast lift designed to correct as much of your tubeous breast anatomy as possible. You may be happy enough with that change. Implants will widen the base width of your breasts, but an implant that is too wide can create a double-bubble deformity which is unsightly. Personally, I would recommend an implant at a later stage after you've recovered from tuberous breast correction surgery.

Your photographs show excessive space between the medial aspect of your breasts, sagging and large areolas.  There is a new technique called "The Ultimate Breast Lift" which can move your breasts medially and upward creating the desired cleavage and lift.  This technique will also reduce the size of your areolas to a more normal size.  It also preserves the ducts and nipple sensation and should not interfere with future pregnancies and breast feeding.  This technique can be done WITHOUT a vertical scar as well.

Best WIshes,

Gary Horndeski, M.D.

Difficult problem and many different ideas, but first things first. The best solution is not in one magic operation.  An initial breast lift would control the position of the breast mound and the size of the areola. Once healed, you could consider a breast augmentation if you are are not happy with the overall size. Minor modifications can be done to the lift to  improve breast shape at the time of augmentation. If you need more volume to get more cleavage then I would consider fat grafting to the central portions of the breast in order to give more fullnes in the center at a third stage.

Time is on your side. 

In your picture, you have ptosis (drooping) and also widely spaced breast.  The ptosis is making the width look wider.  I would suggest a small implant and a lift.  This can help add volume to the breast and improve the shape.  However, an in person consultation and examination would be required to give you more specific advice.

 

Good Luck.