Breasts Too Spaced Apart After Augmentation and Lift

Question

My breasts were sagging and I was a 34 B so decided to have surgery. It's been 2 weeks since I had Breast Lift and Augmentation (255 cc) combined with an abdominoplasty. Right now, my breasts are high and tight, but what worries me the most is that they are too spaced apart. Will they drop and come closer together when the swelling subsides, as I would like a nice cleavage.

Shahram Salemy, MD, FACS · Answer

Some of what you can expect as your final result wil depend on what you looked like before your procedure.  Some women have breasts that are quite far apart, and there is simply no way to bring them as close together as we would like without using a very large implant (even in those cases, it will not always give us the look we want).  
One of our jobs as plastic surgeons is to spend some time with you before surgery and explain what results you can realistically expect to have-- hopefully you had this conversation, but if you didn't, just remember that every patient's anatomy is different, which means that as surgeons our goal is to make you look YOUR best, and sometimes that means that your breast cleavage may not be as dramatic as you would like.
In the meantime, I would recommend patience and wait and see what your final result will be, but discuss your concerns openly with your surgeon.
Good luck,
Dr. Salemy

Olivia Hutchinson, MD · Answer

Some changes in breast appearance will probably occur for several weeks after surgery, and the implants may 'settle" somewhat. The distance between where the breasts are located on the chest, and which creates cleavage, is usually only minimally affected by this surgery, if at all.

Pat Pazmino, MD, FACS · Answer

After a breast lift with implant it is possible to notice a malposition of the implants. If you feel that there is too much space between your breasts, carefully discussed this with your plastic surgeon. Your plastic surgeon before the surgery should have pointed out the width of your chest bone and how close he can safely bring the implants together. It is also important to limit the dissection of the pocket where your implant will reside especially on the sides of your chest. This will ensure that the implant stays only on the front of your chest and does not move too far to the side. If you are interested in a correction for this deformity, discuss with a plastic surgeon the different techniques that they can use to shift your implant more to the middle of your chest and to help diminish that space between your breasts.

Steven Wallach, MD · Answer

Your implants will most likely drop if they are smooth walled.  However, they will not get closer together. Your cleavage is your cleavage and it is very difficult to narrow that region.

Christopher L. Hess, MD · Answer

The space between the breasts is defined by your anatomy.  During breast augmentation the tissue is dissected to that boarder.  So if there is significant space between them, and since the breast size isn't that large you'll have to find a bra that creates the cleavage.
Few women have breasts that will have cleavage, without a bra, after augmentation.  So see your Nordstrom's lingerie department and get fitted.

Bahram Ghaderi, MD · Answer

The spacing between your implants depends on the spacing you have naturally between your breasts before surgery. Some women have wide sternums or breast bones and some have narrow sternums. You do not want to have an artificially created cleavage. The skin over your sternum or breast bone is very thin and if the implants are placed too close you are likely to see the rippling and or the edge of the implants. Review your before photos with your surgeon to see how far apart your breasts were before surgery.

G. Gregory Gallico III, MD · Answer

The shape and position of the breasts will change during the first year after this surgery so give it some more time. The distance between the breasts is partly dictated by the natural distance that was there before surgery. Every woman is different. Implants under the muscle can only get just so close together. They can be brought closer by replacing them over the muscle. But be patient.

Francisco Canales, MD · Answer

Hello Sufri
I would ell you to wait until you are healed before you make any assessment.  The breast implants need to be placed so that they are centered around your nipples.  You cannot bring the implants in too close to the midline without making the nipples appear like they are pointing out more. 
In addition, if the implants are submuscular, there is a limit as to how close they can be to the midline.  Smaller implants have a smaller diameter and tend to be slightly more apart.  For really good cleavage, most Hollywood handlers tell you they tape the stars with good old surgical tape so they look good for those Oscar moments. Hollywood stars look just like the rest of us when they don't have all that help!
Keep you doctor posted on any concerns and enjoy the new look.

Robin T.W. Yuan, MD · Answer

Position of the breasts on the chest is variable with some patients having widely-spaced breasts to begin with. Ideally, the implants should be centered behnd the nipple so that widely-space breasts usually means the implants can be widely-spaced unless a dimension is chosen to specifically address the cleavage or, as perhaps in your case, an operation is performed to move the nipple. In general, implants tend to drift laterally, not medially, since the rib cage on which they sit curves laterally so if your implants are too wide apart, they are not likely to improve the cleavage. However, it is much too soon to really assess your overall results and you might need a period of adaptation. Hang in there, listen to your surgeon's instructions, and don't worry yourself yet over things you cannot control.

Paul C. Zwiebel, MD (retired) · Answer

Congratulations on your recent surgery!  I hope your results are all that you seek.

	The space between the breasts is determined by:

	
		the position before surgery
	
		distance between the nipples
	
		the curvature of your rib cage
	
		the width of your breast bone (sternum)


	There is really nothing a plastic surgeon can do to create cleavage in the sense that the breasts touch each other even without a bra.

	
		Implants add volume so you can push the breasts together with a bra.
	
		Breast lift improves shape and position of the breasts and nipples, but you still need to use the bra to "smoosh the breasts together for the amount of cleavage you want to create.

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