What will close the gap between my breasts? (Photo)

Question

First picture is me, other my wish boobs. I am very unhappy with how spaced out and round my implants look. I originally wanted Mod Plus implants but was talked into High Profile. Would this have made a difference in how spaced out and round my breast are? Also, I was hoping for larger implants but was told I wouldn't be able to go any larger. Would my frame allow for Mod Plus/400cc? Current: 5'0, 110 lbs, 300 cc HP

Edwin C. Pound, III, MD · Answer

The width of your cleavage is defined by the width of your chest bone.  With that in mind, I always caution patients to be careful when trying to create cleavage surgically.  I have seen a lot of bad results come through my office needing revision.  First, there is nothing much covering that chest bone other than skin.  If there is any rippling/wrinkling of the implant in that area, it may be seen/felt through the skin which might negate being able to wear anything low cut.  Secondly, the implants should be centered behind the nipple/areola.  If they are centered more towards the middle of the chest then the nipples may rotate outwards causing them to point towards opposite walls.  I have seen patients with that problem come through my doors.  It's not that hard to fix but it requires another surgery.  Implants are designed to add volume to the breasts, not change the shape.  That's why God made push-up, push-in style bras!  As for your size, you could certainly go larger if you wanted to.  If your doctor doesn't want to do it then come on down and see me!

Thomas A. Mustoe, MD, FACS · Answer

Larger implants with larger base diameter (moderate plus) will help.  You are thin and fat grafting to the sternal area will also help.

Sheila S. Nazarian, MD · Answer

Your cleavage is literally restricted by your anatomy. You can manipulate it to a certain extent, but it is imperative that you have realistic expectations. Best, Dr. Nazarian

Paul Vitenas, Jr., MD · Answer

Thank
you very much for your question and photographs.  From your picture, it would appear that a
moderate profile implant, of significantly more volume, would be indicated to
give you a result which is closer to the ‘wish boobs’ that you have posted.
That being said, your breasts can never be made to look exactly like your dream
breasts because you have a fairly wide sternal breast bone.  Your natural anatomy prevents the kind of
cleavage closeness seen on your wish boobs. 
Fat grafting to the medial aspects of your breasts, along with a larger
implant, would be a viable option to produce as close to the desired result as
is plausible, given your anatomy.  I
would recommend that you schedule a consultation with a Board Certified plastic
surgeon to further discuss your physical situation and goals.

Nelson Castillo, MD · Answer

Thank you for your questions and photographs.  I am sorry that your results have not been what you anticipated.  Though the gap is heavily dependent on your natural anatomy it does appear that wider, larger breasts will help better approximate your desired "wish" pictures.  You may require some work on your implant pocket to help lift your implants higher into your chest as well as possible ancillary procedures such as fat grafting to further maximize results but this is best determined through an in-person examination.  Be sure to see an ASPS board certified plastic surgeon.

Charles Galanis, MD · Answer

Much of this question depends on your preoperative anatomy.  Some women have breasts which are naturally spaced out.  Augmentation is not intended to necessarily displace your breast from one side to the other.  The implant needs to be placed behind your existing breast.  If you try to create a pocket that is more toward the middle, you run the risk of the nipple not being centered on the implant and even pointing out to the side.  As far as what size or style implant is appropriate for you, that is based on multiple factors that fall into two categories: patient goals and patient anatomy.  There are many ways a surgeon has to clarify a patient's goal size including external sizers, 3D imaging, or even bags of rice beneath a pad-less bra (1 oz rice = 30 cc of implant volume).  Regarding patient's anatomy, breast width, skin laxity, nipple to fold distance, and other measurements all go into the decision of what style would work best.  So these anatomical factors must be weighed against your goals to come up with the most appropriate plan.  Only an examination with a board certified plastic surgeon can yield a more definitive answer to your question.  Hope this helps!

Mark A. Brzezienski, MS, MD, FACS · Answer

The space between you breasts is dictated by the insertion of you pectorails muscles medially, if you have sub-pectoral implants.  Even in "above the muscle" BAM, one must be careful not to create a Symmastia with the implantation technique.  ---one breast across your chest---Far better is the idea of adding some controlled fat injections to the medial portion of the breast.  Most women have some fat somewhere that they are willing to contribute, and the result is controlled and natural without risking implant deformities.We do it all the time in breast reconstruction...Now it is should be and is being applied to BAM technique.It's called a "Composite BAM".

Darryl J. Blinski, MD · Answer

Sorry to say your anatomy does not allow a better cleavage result. Best to hear this in person than over the internet. seek more in person examinations...

Robert H. Hunsaker, MD · Answer

Based on your photos it appears to me that you could achieve significantly improved cleavage, though maybe not as close as your wish photo (would need to examine you). You can also accommodate much more overall volume. The increased width of the new implant is most important with the projection(profile) then providing the increased fullness.

Ciro Adamo, PhD, MD · Answer

Breast augmentation cannot give a significantly narrower cleavage. Implants in fact have to be placed centered on the nipples to avoid displacement (nipples pointing outward, if the implants are placed too close to the midline of your chest). In theory, using very wide implants would allow to make the cleavage fuller, but any gain toward the midline would be identical on the lateral side of the breasts, toward the axilla. This would give a very bad shape, with high risk of rippling.The choice of profile does not significantly change the cleavage, which is mainly determined by how wide an implant is. For the same volume, high profile implants are narrower than moderate profile ones, therefore they give a wider cleavage. If you wanted to use high profile implants and get the same cleavage that you have got now, you would have had to go bigger in size.

What will close the gap between my breasts? (Photo)

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