Can Breast Muscles Be Tightened to Create More Cleavage?

I have 300cc saline, high profile. I'm 5" 103 lbs, I feel like my breast are seperated and under my arms. what can I do?

Doctor Answers 22

Breast implants under arms and not in position? Breast Augmentation.

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Generally when I see laterally shifted implants it means the patient had an axillary incision for placement.  Although this is an accepted incision, all too often the path of surgery becomes the lateral path of travel for implants.  Larger implants and more medial dissection will help.  At times lateral pockets can be sealed and implants shifted medially but this is a big job.  Lastly, implants can be removed for 3 months while the pocket seals and then replaced.  Some patients have a wider sternal area and a great cleavage is not possible.   Do you have photos?  That would help.  Possibly you will be just fine with time.  My Best.

Improving Breast Cleavage

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Hello and thank you for the question.

There are several factors which contribute to intrinsic cleavage following a breast augmentation. These include implant selection, soft-tissue plane (submuscular versus subglandular), width of the breast bone (sternum), as well as the native position of the breast parenchyma on the chest wall. Taking this into consideration, revisional surgery can be performed to improve the cleavage in select patients. Without having the luxury of examining your first-hand or seeing photographs, it is difficult to make that determination. I recommend you followup with a Board Certified Plastic Surgeon in your area for an evaluation and opinion.Kindest Regards,

Glenn Vallecillos, M.D., F.A.C.S. 

Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Breast implant location

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The placement of an implant below the muscle can lead to a lateral position of the implant in time. I find that the larger the implant is, the greater the tendency for the muscle to push the implant down and out. Muscle tightening will actually make the problem worse. In your scenario it will either require a larger submuscular pocket  being made if possible, or the repositioning of the implants above the muscle.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Breast Implants - Implants Have Shifted Too Far Laterally

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Hi maxinemax in Allentown, PA,

It can be hard to get exactly the look you want but I generally prefer moderate plus implants (neither the high profile, which often leave too wide a gap between the breasts nor the low/moderate profile, which are too flat and extend too far into the axillas).  In your case, though, you may now need textured implants (so that they will be less likely to shift) and/or have the pockets sewn off laterally to, similarly, prevent a lateral shift.

You should, of course, talk to your plastic surgeon and/or any other surgeons who can examine you in person.

But I suspect that switching to a different profile implant with, possibly, some adjustment of the exact dimensions of the pocket(s) will produce the result you're looking for.

I hope that this helps, and good luck,

Dr. E

Changing Position of Implants

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It appears that you are satisfied with the size of your implants and how they fit your body shape, but are unhappy with the position of the implants – they have a "lateral displacement". From time to time, we see patients with this problem and they are looking to get better cleavage. This can be done with changing the implants, opening up more of the inner part of the breasts, and closing the outer breasts, with a procedure called capsulorrhaphy. During this operation you would have a chance to change your implants size, or keep them the same size.  Similarly, you may choose to convert to silicone implants, which feel softer than saline implants.  However, if you are not having any problems, you can keep the size and type of implants the same.  


Breast augmentation

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You may need to have your muscle released more in the midline to gain greater cleavage. It doesn't help that you have high profile implants as these implants in the size you have are fairly narrow. Switching to a wider profile would help as well as the muscle dissection.

David E. Kim, MD
Beverly Hills Plastic Surgeon
4.6 out of 5 stars 106 reviews

Cleavage may Vary

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There is no procedure on the chest muscles in plastic surgery to create tight cleavage. High profile implants have a narrower diameter than other types of implants.

  • By changing to a moderate profile you will add a little to the breast width giving you better cleavage. If your breasts are under your arm it is because your implants have pushed out the side tissues.

Several years ago, I changed my technique of pocket dissection so as NO pocket dissection is done on the sides. In order to correct your problem, you will need a pocket closure operation.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon

Cleavage after Breast Augmentation

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Follow up with your Plastic Surgeon. Breast Augmentation carries a national surgical revision rate of 25%. You may need a smaller capsule or a breast lift or a switch to submuscular space. It may be due to your pre-operative anatomy.

Good luck,

Leo Lapuerta Jr FACS

Triple Board Certified Plastic Surgeon

Leo Lapuerta, MD
Houston Plastic Surgeon
4.3 out of 5 stars 48 reviews

Cleavage is achievable. It's the pocket and implant style that has to be spot-on.

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When considering the final implant size for my patient, I always consider the chest wall configuration and the patient's desire for cleavage.  Implants take up space on the chest.  If the pockets come pretty close together in the center, you get great cleavage.  Too close, and you can get a weird look in the cleavage area called synmastia.  We choose the correct implant diameter to come close enough for cleavage without that complication.  I get the patients' consent in advance to try several sizes before choosing the proper implant during the surgery.  I am not one of those surgeons who believes you can tell the exact size that is best for you ahead of time.  500's will look different on you than they will on your girlfriend.  In cases where the pockets are too far apart (like you) a little pocket work and different implant will probably fix it.  Maybe even the same implant.  We tend to suture pockets, not muscles in surgery.

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Can breast muscles be tightened to create more cleavage?

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Everyone wants the best possible cleavage after breast augmentation.

Your final cleavage will depend on:

1. the cleavage you have before surgery. The more you have before you go into the operating room, the more you will have coming out.

2. the size and width of your implants. Don't forget that for a given volume, high-profile implants are the narrowest and can leave you short on cleavage.

3. the type of implant. Saline implants are heavier than gels and have a definite tendency to drop out to the side as time goes by.

You don't mention how much time has passed since your surgery. It may be worth while consulting an experienced plastic surgeon to see whether your result can be brought closer to what you would like.

Good luck!

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.