Can you create a wider cleavage gap in a breast augmentation?

Question

I would like a breast aug for upper pole fullness, but I don’t like how close together my breast are right now. I’m worried adding implants, I’ll just have a line for cleavage rather than a nice gap in between with a rounded shape.

Daniel Barrett, MD · Answer

Dear Good753464,

many women seek improved cleavage. Narrowing the cleavage plane can be done very carefully by a skilled surgeon. Moving the implants too far medially can result in synmastia or unaboob which is very difficult to correct. That being said, the right amount of pocket dissection and implant selection can create excellent cleavage.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

It is important for patients to understand that augmentation will "augment" all aspects of your anatomy. The spacing of the footprints of the breast on the chest wall will vary from one individual to the next. Widely spaced breast will appear more widely spaced and vice versa. 
The spacing (cleavage) is defined by the pocket. The pocket is defined by the plane of augmentation.When placed submuscular, the medial/middle limit is the sternal origin of the muscle. Wide sternum  greater separation of the breasts  less dramatic cleavage. This space can be narrowed (with some risk of synmastia) when the devices are placed subglandular or "over" the muscle. There is no muscle obstructing a medial push, however, there is a higher risk of over-dissection and midline migration of the implant (the dreaded "uni-boob").
With regards to your specific question, a higher profile device is narrower but will project more. A wider device can create the illusion of closer spacing between the breasts (when placed subglandular). Most patients will fit into the "moderate +" category...but this will depend upon the measurements of your breast width. That being said, it is never recommended that you stray far from your unique BWD.
And remember...love the look you choose...not the cup you desire.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ted Eisenberg, DO, FACOS, FAACS · Answer

Implants don't change your shape or build cleavage. They only take what you have and make them fuller. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Zoran Potparic, MD · Answer

By selecting  implant with a base (footprint) smaller than breast footprint one can avoid affecting the cleavage but contributing to volume of upper pole. Hope this helps.

Ira H. Rex III, MD · Answer

This is tricky.  Often the cleavage, whether close or wide, stays about the same.  A large implant would likely increase the central fullness as you have mentioned.  A breast reduction might be considered, with placement of an implant.  The closeness of the cleavage will probably be about the same, but you would probably have a more open appearance, without the breasts pushing on each other as much.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs. Breast implants have to be centered underneath the nipple-areola complexes. If your breasts are too medial now and you do not like it then implants will not solve your problem. You may need repositioning of the nipple-areola complexes using a donut mastopexy.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Michael S. Kluska, DO · Answer

implant size and positioning is customizable to each patient. It’s very hard to answer this question because I don’t have photos to see what you’re underline anatomy is.

Ahmet Bilirer, MD · Answer

When performing breast augmentation or placing implants, the main goal is to achieve upper pole fullness and an aesthetically pleasing breast shape.
However, one key anatomical factor that significantly influences the outcome is the placement of your breast footprints. If your natural breast footprints are widely spaced, your breasts will naturally sit further apart after augmentation. Conversely, if the footprints are close together and there is minimal space between your breasts (cleavage), the result will likely reflect that as well after implant placement.
In some patients with symmastia (where the breasts are very close or appear joined in the center), certain surgical techniques like anchoring the skin to underlying tissues have been attempted, but these methods often yield limited success.
If you are able to share a photo, I could provide more detailed and personalized feedback. However, in general, the position of your breast footprints gives us important insight into what kind of outcome to expect after breast augmentation &mdash; and it is not something that can be easily altered.

Can you create a wider cleavage gap in a breast augmentation?

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