Breast Implants and cleavage gap
Thanks for the question. There are several factors which come into play when determining the ideal fit of an implant for a particular body habitus. These include base width, amount of native breast tissue, soft-tissue pinch width, nipple-inframmamary fold distance, and soft-tissue laxity. Additionally, studies have shown that, in general, ?implants larger than 350 ccs induce predictable negative consequences over time on the tissues of the breast. Its a good idea to keep that in mind when undergoing a breast augmentation.
I would find it hard to believe that you BW is actually as high as you state. I recommend you have a consultation with a qualified plastic surgeon who is well versed and experienced in breast augmentation surgery. Ask plenty of questions are review all possible options, including implant sizes. There is an ideal implant size for your body which will balance your proportions without giving you the "beach ball" look.
Best of luck!
Natural appearing breast augmentation
Unfortunately the most commonly used type of implants (high profile) and the most common type of placement ( submuscular/dual plane) cannot deliver the natural 'tear drop' effect or cleavage that you desire. Leaving the origination of the pectoralis major medially intact in submuscular placement ensures that the implant cannot be medial enough to look natural, and a flat plateau is left centrally. There are also big problems associated with anatomic implants placed in conventional planes( they work well in subfascial carefully designed pockets). This is why I use a very unique methof of breast augmentation that I call 'cold-subfascial augmantation.' the placement of the implants is not 'above the muscle' or subglandular, nor is it submuscular or dual plane. A very strong layer of connective tissue is meticulously and atraumatically dissected from the pectoralis major muscle and this tissue is used to shape and support a lower profile implant into a gentle tear drop shape. It is the surgical dissection and not the implant itself that gives shape to the breasts. The results sit like natural breasts and do not move like submuscular implants do with arm motion. The fascia also supports the implant giving it relative protection from gravity and aging.
All the best,
Rian A. Maercks M.D.
Breast Implants For Fuller Natural Cleavage
I believe you are a good candidate for breast augmentation. I prefer the dual plane (aka split muscle technique) for my breast augmentation procedures. I believe you have achieve a nice soft natural look avoiding what you call "the beach ball" look. Implant selection will be very important as well. I'm glad your surgeon is considering your base width (chest wall dimension). I consider two factors when selecting implants for my patients:
2.Gel Implant Sizing system
Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. Even your fitness levels and other relevant criteria are taken into consideration. It is you who will decide what you are comfortable with.
Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for.
This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.
Breast implants for natural look without big gap.
Most of the time the goal is to have a 2 to 4 cm space between the breasts. This can vary from patient to patient. A board certified plastic surgeon can make the distance smaller. If too small there is a risk of symmastia. Each patient's chest wall and soft tissue is different. There is an interaction between the chest wall, soft tissue and the implant itself. This can drive the implants apart at times. Cleavage comes from bras that push together the upper pole. Make sure you tell al of your concerns to your board certified plastic surgeon. Bring photos in if you can find ones that you like. Together you will make a plan.
Minimize Gap Between Breasts on a Wide Chest
you for your question. You are a great candidate for breast implants.
The implants will give you more fullness and rounder breasts. Cleavage
will improve but not significantly because of your anatomy. Choose a
board certified Plastic Surgeon. Best wishes
Size Is Important-- Use 3D Imaging To Resolve Anxiety
One of the
most important decisions facing breast augmentation patients is the size of
breast implants that will be used.Most
patients are striving for harmony, balance, and proportion with the surrounding
anatomic structures.Typically, they
want a natural look with some fullness in the upper breast area.
Patient consultation is the starting
point for their decision and every effort should be made to have good
communication.Most patients tend to
talk in terms of cup size.Unfortunately,
cup size isn’t always helpful because manufacturers of bras label their
products differently and women don’t always wear their bras the same way.In other words, some women wear their bras
snugly, while others wear them loosely.This creates communication problems when talking cup size.
In an effort to determine breast
size in a more objective manner, we utilize external silicone sizers and the
Vectra 3D computer imaging system.External silicone sizers are designed to sit on top of the patient’s breasts.They can be held against the patient’s chest
or placed inside the patient’s bra.This
technique helps the patient visualize what their breasts will look like with a
specific sized implant.It also gives
them a sense of the volume that will sit on their chest wall and how it feels.
The 3D Vectra imaging system is a
relatively new technology that we have found to be extremely helpful for
determining breast implant size.This
system allows a patient to visualize different sized implants on their actual
body.Patients find this to be extremely
The ability to visualize your
projected surgical result alleviates much of the anxiety associated with this
procedure.We feel that both the use of
external silicone sizers and the 3D Vectra imaging system accomplishes this
goal.It’s important to remember that
final adjustments in the size of breast implants will ultimately be made in the
Operating Room, depending upon anatomic factors.
Post-operative cleavage will depend on your pre-surgery cleavage. You have wide-set breasts, which means you'll probably continue to have wide-set breasts after surgery. However, while you may have a bit of improvement, it may not be as much as you want. Unfortunately, your surgeon can only do so much to give you cleavage before it looks abnormal, since the implants have to remain centred underneath your nipples.
16-18 sounds a little high from looking at your photo. But an experienced plastic surgeon should be able to give you an idea of the cc's you would need to get to the size you want.
Much of the final “look” achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
Dear Joan, You have beautiful shape to your breasts and I would think and implant in the 350 to 400 cc range may well meet your goals but I have not examined you. I doubt that your breast base width is actually 16to 18 cm. How tall are you and how much do you weigh? i can understand your anxiety about implant size if these are accurate measurements. Who measured your breasts?