Why are my breast implants so far apart? (Photo)

Question

It has been 11 months since my breast augmentation. I had 295cc natrelle silicon high profile implants. I know that with my body's anatomy that there will be a natural gap between my breasts. But why is there SO much cap? My breasts are practically in my armpits. I also feel like they look as they are bottoming out sometimes. Can anyone let me know if this is normal or if a revision would fix?

Chet Mays, MD · Answer

Thank you for inquiry.  Implants will typically follow the natural anatomy of your upper body.  There are ways to help support the implant.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice almost 30 years and revisionary breast surgery is a large portion of my practice. Your situation is not uncommon. In an attempt to avoid a lift, your surgeon placed your implants quite low on your chest. The action of the pectoralis muscle will push your implants down and out with much more efficiency then if the implants were higher up on your chest. You definitely needed a lift from the beginning and placement of your implants in a much higher location. At this time, you would benefit from an internal bra-capsulorrhaphy and a lollipop mastopexy-lift. You should be able to have an excellent result.  Best wishes to you.

Gary M. Horndeski, MD · Answer

At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Dana Goldberg, MD · Answer

Your implants are centered around your nipples. Revision might improve the position some (especially if they fall further to the side when you lay down), but they will never be significantly closer together.

Connie Hiers, MD, FACS · Answer

Part of the reason that your implants are far apart is your bone anatomy which cannot be changed.  However, the lateral pockets could be tightened some to bring the girls a little closer together.

Mats Hagstrom, MD (license on probation) · Answer

When women have breast that are divergent and or sit wide on the chest wall, the plastic surgeon has to decide if they should put the implants the breast should sit in an ideal position or rather center the implant on each breast.
If your breast were put in the midline in order to get a cleavage look then the implant would not be centered on your breast and that would look odd as well.
Plastic surgeons cannot move your breast on the chest wall With the exception of a lift which is moving the breast back to where it used to be. 
Women who have breast that are divergent or sit wide on the chest wall are therefore not ideal candidates for breast augmentation.
This should be discussed during the consultation.
Personally, I believe the implants should generally be centered on the breast, regardless of where the breast sits on the chest wall.
This gives a more natural appearance and stay consistent with the persons inherent body.
I think the most important issue is communicating this before surgery so the patient understands the implication of having breast implants.
 When patients are not ideal candidates for breast augmentation because of breast position on their chest wall or breast divergence then these variables are generally amplified and put on display with the projection of the implants.
Some patients don’t recognize how much of a variable this was when the breasts were small, but not that far more with the argumentation.
This is not the surgeons fault other than in a perfect world. The surgeons would make the patient aware of it before scheduling the procedure.
Best,
Mats Hagstrom MD

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