Do you think I could achieve close cleavage based on my natural breast pocket shape? (photos)

Hi Willofran,

Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.

Implant profile is one of the important considerations to make. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This is associated with several problematic consequences.

The first issue is that the patient loses width and therefore cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants.

High profile implants do have a role in symmastia repair (when I need to narrow the base width) but otherwise I try to avoid them.

When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.

Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.

Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Cleavage is created by clothes. Having bigger breasts will make it easier to create cleavage in clothes.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author 

Your cleavage can certainly be improved with a breast augmentation.  You are correct that every individual has a natural breast location on their chest, some closer than others.  However, an implant can be placed more towards the midline. In the sub muscular placement, the placement is limited at the point that the muscle attaches to the sternum/breast bone.  Further muscle dissection is not recommended.  If you have questions, get several opinions from board certified plastic surgeons. Best of luck.

Dr. E Wright

Dear WilloFran,   Thanks for posting your picture and your wish pictures. From observing your picture, you appear to be asymmetric small A cup size (left breasts is bigger) and wide cleavage. Your wish picture appear to be C or full C cup size.   I operate on patients like you weekly and I can tell you that you can have very nice cleavage. The critical part in creation of nice cleavage is dissection of  the Pectoral muscles medially , close enough to the midline and having, at least,  a moderate  size implants. It is also important not to over dissect the pockets laterally, to avoid implants displacement under the arms pit.   As far as size selection, if you are currently 32 small A cup size, to become 32 full C you will need implants with volume of  400 cc. For 32 C - 325 cc.    You have to understand that not all results are the same because experience, technical skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely.   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.                      Best of luck,                                  Dr Widder

Hello and thank you for your question. You are a great candidate
for a breast augmentation with improved cleavage.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

The presence or absence of cleavage is dictated by where your breast base is positioned on your chest. If you have got a wide distance between your breast bases in the middle, then you would have a wide cleavage even after breast augmentation procedure, although this will be less than before the augmentation. This is because your implants need to be placed under the centre of your breasts. Any attempt to place the implants towards the centre of the chest could result in your nipples being offset and to the sides of your newly augmented breasts. Some surgeons advocate using wide implants to improve cleavage. This will obviously improve cleavage, but you do need to be aware that this will also mean your implants / breasts being prominent in the sides, under your arms. Cleavage is some thing that matters most in a dress and you will always have a nice clevage in a bra that brings the augmented breasts together.

 

For optimal outcome, please consult a fully qualified plastic surgeon, who has specialist qualification in plastic surgery 'FRCS Plast' after having being trained adequately in the field of plastic surgery, is registered on the 'Specialist register for Plastic surgery' with the General Medical Council and has been considered competent enough to be a member of the 'BAPRAS' (British Association of Plastic Reconstructive and Aesthetic Surgeons) and 'BAAPS' (British Association of Aesthetic Plastic Surgeons) at the least.

Thanks for your photo and question.
You don't have an excessively wide cleavage gap to start with, and I think you would achieve a lovely result from standard breast augmentation with implants. However the photos you showed - even those without very supportive clothing - show really quite a narrow cleavage gap. If you are interested in achieving that kind of result then you should also consider the use of fat grafting in addition to breast augmentation with implants, directed towards narrowing the distance between your breasts. You are slim but there is usually enough fat in one or two places to enable this.
Best of luck! 

Thank you for your question and photos.  From your photo you have mildly wide breast bone which limits your cleavage.  Your choice of implant size and shape should be determined at the time of your consultation taking into account your measurements and tissues.  My patients find the 3D imaging with Crisalix very helpful in deciding on their optimum implants.  You should achieve a very nice result following your surgery.  Good luck.

Your natural breast "footprint" will allow cleavage in the upper and mid chest areas, similar to some of the pictures your have chosen with people in clothes.  The fourth picture is not realistic as it has very little distance between the round lower poles of the breasts while your natural breasts will always diverge in the lower one-third.  Dr. Z

Thank you for your question. The amount of cleavage after breast augmentation depends on where the chest muscle inserts on the breast bone. The cleavage shone in the photographs in the bikini are not realistic as the bikini is pushing the breast implants together. However the one patient without a bikini has very close cleavage that may not be possible after breast augmentation.You do have somewhat wide set breasts However breast augmentation will definitely improve your cleavage but not to the degree shone in your desired photographs.