Are my breasts too wide set to ever have any cleavage after breast augmentation? (photos)

Question

Interested in an IDEAL implant, but my breasts are so far apart I’m worried that after healing, not even a push up bra would bring them together. Also I’m interested in a much larger size, would a goal of DD or DDD cup be out of the question for someone with such small breasts to start with?

Michael S. Lofgren, MD · Answer

Thanks for the question and photos.
Couple of thoughts and observations.  You are correct in recognizing that your breast are rather wide set on the chest.  This certainly can make the formation of cleavage after a breast augmentation difficult.  Especially if you want the implants placed under the muscle.  Placing them under the breast tissue only, on top of the muscle can allow the implants to be placed more towards the center of the chest.  There are advantages and disadvantages of placing the implant in either position.  This is a discussion you should have with your plastic surgeon.
Secondly, wanting to go significantly larger (DDD cup) may be a physical impossibility. (In one surgery at least.)  Your body will dictate what is the maximum size implant that you can possibly fit into the breast.  Things like width and height of the breast, anticipated skin laxity, amount of current breast tissue all go into determining the largest implant you can use.  The only way to know for sure is to have a face to face consult with a plastic surgeon well versed in breast augmentation.  They will take multiple measurements and can give you an idea of what implant sizes are available to you.   Also, the largest currently available Ideal implant is 755cc.  Keep in mind that this may or may not get you to a DDD.  
Best wishes!

Jed H. Horowitz, MD, FACS · Answer

Good day! Thank you for providing photos with your query. For your guidance, here is a list of generalized breast implant sizing for most patients:
32A to 32C needs about 250-275cc34A to 34C needs about 300-350cc36A to 36C needs about 350-400cc  It is best to find a size in proportion with your whole body. The placement of the implants are also important so as to not have a "popping out" since you are relatively thin. Contact your surgeon and discuss realistic goals and expectations when deciding what size is the best for you. Best of luck! #RealSelf100

Mathew A. Plant, MD, FRCSC · Answer

Without examining you it is difficult to be certain but it appears as though you have a mild form of tuberous breasts. This is what is causing your breasts to look like they are so far apart. It’s also something that can be corrected as part of a breast augmentation as long as your surgeon recognizes it and releases the constricted areas appropriately. You may not be able to go from your current size to something as large as a DDD in one operation but if you end up that large you will certainly have the ability to give yourself clevage with a push-up bra. Meet with a few board-certified plastic surgeons in your area until you feel comfortable that one can do the job that you want. Best of Luck!

Ira H. Rex III, MD · Answer

You can usually expect a cleavage after breast augmentation to closely match that which you have before augmentation. When you're result softens up, he will have some leeway as far as moving the implant closer together with the right dress or bra. Going with a larger implant will not help this, and will probably accentuate your native nipple position as pointing to the side.

Steven L. Ringler, MD, FACS · Answer

Thank you for your question and the photos.  Your breasts are somewhat widely spaced, and you most likely will still have a gap following breast augmentation.  The size of implant that can be used is dictated by your own desires but also your anatomy.  Physically, you don't want implants that look unnatural and go beyond your own body frame.   Seek out a board certified plastic surgeon with extensive experience in breast augmentation.  Many plastic surgeons have 3D imaging as well as sizers that will show you how various size implants will look on your own body.  Your doctor will also take measurements and make recommendations as to how you can achieve the best results based on your goals and anatomy. I wouldn't focus too much on bra size, as this varies between manufacturers.  Best of luck to you.

Ronald Schuster, MD · Answer

Yes, your breasts are very far apart. I think that the larger you go the worse they will look. I would suggest modest moderate plus or even low profile implants. You might also benefit from additional fat grafting which could help improve overal breast proportions in areas hat the implant can't reach.

Benjamin Van Raalte, MD · Answer

The amount of cleavage you get with breast implants depends on the following:1. How much breast tissue you start with, those with the most, will have more cleavage.2. How wide your breast bone (sternum) is. Those with a wide sternum will not have as good of cleavage. How thick your pectoralis muscle is and how much is released also may affect.3. How tight your skin is. Tight skin will only allow a smaller flatter implant.As far as the surgery to improve cleavage goes:1. A larger implant may produce more cleavage. A form stable textured implant may stay more medially for better cleavage.2. Going above the muscle may allow the implants to be closer. I would only go over the muscle with a textured form stable implant.3. Fat grafting could be done later for more cleavage.

Paul J. Leahy, MD · Answer

Thank you for your question. I do think that your anatomy is not going to allow for placing them very close together as you are thinking. Also, I don't think you can get an implant size that will get you to DDD (maybe not even DD). Trying to do both of these maneuvers are likely to end up with poor results and complications. Best wishes to you

Jonathan Hall, MD · Answer

This is a common question from patients.  Breast implants will add volume to your existing breasts, but they do not change the position of the breasts.  The implant needs to be centered underneath the nipple, so if your breasts are widely spaced before surgery, they will also be so after surgery.  It the implant is placed too close to the center in this case the nipples will swing out and appear "wall-eyed" . It is important to select the proper implant to enhance your appearance that is based on your anatomy.  After you are healed you can still use a bra to enhance your cleavage-you will have more volume to work with after an augmentation.  This is not a reason to not have the IDEAL implant.  We talk about patients "wishes" vs patients "tissues".  If the width of the implant is wider than the base of your breast, it will look unnatural.  So in addition to not looking natural, which is my goal for any plastic surgery procedure, an implant that is overly large for someone with tighter tissues can stretch and damage your tissues.  So a DD/DDD is not recommended.  It would be helpful for you to have an in depth consultation with a board certified plastic surgeon so that you can truly understand the trade-offs of the different decisions that are made in breast augmentation so that you can choose the trade-offs that are best for you both tomorrow and in the future.

Are my breasts too wide set to ever have any cleavage after breast augmentation? (photos)

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