Gap on the Upper Pole Bigger Than in my Natural Breasts? (photo)

I got 175cc textured silicone implants over the muscle about 6m. ago. My chest diameter all around is 281/2". The gap on the upper pole is bigger than in my natural breasts. They look like balls now and the line on top goes inwards rather than straight. Why is that? My doctor said before surgery that my chest is very narrow but although being very thin my chest at 28" and more is not very narrow, is it? Should he have used moderate profile instead of mod+? . Can that be corrected and how?

Doctor Answers 8

Gap on the Upper Pole Bigger Than in my Natural Breasts?

Sorry to read of your disappointment in your results. The post op picture is less than ideal since you are clothed, but it shows the issue well enough it seems. 

I would suggest moving the implants behind the muscle, and switching to smooth moderate profile to improve your outcome. All the best. 

Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Unhappy after Breast Augmentation Surgery?

I am sorry to hear/see your dissatisfaction after breast augmentation surgery. In my opinion, you would have been better off with the use of larger/wider silicone gel breast implants placed in the sub muscular position.  Revisionary breast surgery will be helpful to you at some point;  select your plastic surgeon carefully. Ask to see lots of examples of his/her work and communicate your goals carefully. I find the use of goal pictures helpful during this communication process.

 I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Sometimes breast implants can be too small.

175 mL breast implants have a very narrow base that may not extend as far as the normal anatomic limits of the native breast. This is something you should discuss with your plastic surgeon.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Gaps and unsightly contours 6 monts post-op after placement of silicone implants

Two criticisms I can make right off the bat with regard to your surgical plan are that your implants were either the wrong size/dimension and your implants should have been placed under the muscle.  While there are some downsides to submuscular placement, like some slight increase in discomfort and recovery time, the advantages far outweigh the disadvantages.  One of the main advantages is that the muscle provides coverage for the implant, especially in girls like you with very little of your own natural tissue to camouflage the implant contour.  In particular, if done properly, this should produce a very soft, natural cleavage, because you are correct, your preoperative cleavage was nicer than you have now.  Without that you get what you are seeing now - a well defined contour of the implant visible beneath the thin tissues.  If you have enough fat to harvest as a graft, sometimes that addition of fat to the breasts can also soften stark implant contours as well.  With regard to the implants themselves, I would suggest reconsidering either the size or profile width of the implants to better cover your chest wall, and you might even consider an anatomically shaped implant in a slightly larger volume as this will create better lower pole fullness and less of the round, "ball shape" at the top of the breasts.  Find a well-qualified board certified surgeon with experience in all types of breast surgery so that you can review all of your options.  Especially in Europe you should be able to find a surgeon with experience in using anatomically shaped implants, and I think this is an option which would be important for you to at least explore and consider.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

The importance of base width in breast augmentation.

Your experience demonstrates two things: the importance of establishing the correct base width in breast augmentation and the problems of implant concealment when there is very little body fat.

175cc implants are so small that even in low profile their base width is tiny and clearly inadequate for your frame. You may have to accept larger volume implants simply to get a base width to fit your chest.

With so little body fat, the imperfections are all the more obvious because they cannot be concealed by the usual blanket of fat. For this reason, many plastic surgeons place the implants beneath the muscle, particularly when the patient is thin, so as to hide their ('ball'-like ) outline and produce a more natural contour.

However, with average body fat and some pre-existing breast development, placement in front of the muscle is quite acceptable.

J. Brian Boyd, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 5 reviews

Dimensional Planning a MUST!

No one should be getting 175cc implants. That's a 9.9cm base width and far too narrow. It's interesting that the majority of patients that I revise from central and south america are always undersized on the width and volume they require. All I do is place a dimensionally appropriate implant and suddenly these patients think I am a magician, when in fact all I did was some basic measurements and selected an implant based on those measurements, rather than fixating on the cc volume!

Evan Feldman, MD, FACS
Texas Plastic Surgeon
5.0 out of 5 stars 86 reviews

Large gap in upper pole

Given how slender you are, I think you would get a more natural result with implants placed below the muscle.  A 175 cc implant is very small and therefore has a small diameter, especially since it is a "moderate plus" profile implant.  This contributes to the large gap.  Based on your photos, I would have recommended silicone gel implants in the 250-300 cc size range placed below the pectoralis muscle.  Yes, it can be fixed, but you will need additional surgery.  

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 98 reviews

Gap on the Upper Pole Bigger Than in my Natural Breasts?

Based on your photos, I think that "they look like balls" because you have very little breast tissue and textured implants are designed to help the tissue adhere to the implants.  I would go back and discuss it with your PS but you may want to consider smooth silicone implants with a wider base diameter so that they fill your chest width better.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.