Can a doctor change the spacing between breasts?

Thank you for the question.  Generally speaking, patients undergoing breast augmentation or  revisionary breast augmentation surgery should understand that their anatomical “starting point” will play a significant "role" in the outcome that they can expect with breast augmentation surgery.   If the patient starts out with a significant distance between the breasts, there are limits as to how close of "cleavage" can be achieved.  If over dissection (when developing breast implant pocket) occurs in the cleavage area, with the goal being to achieve as close as possible cleavage per patient's request, patients may experience significant problems such as breast implant displacement (medial  malposition or symmastia) and/or significant breast implant rippling/palpability.  Obviously, these types of problems may require revisionary breast surgery to correct.  

















When it comes to selection of appropriate breast implant size/profile, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.  



 



Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery ( regarding breast implant size/profile selection) is:











1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.











2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 



In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.



Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.











3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.  Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.



I hope this (and the attached link, dedicated to larger breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

Thanks for your question.  The surgeon can improve the cleavage with implants only to a certain degree determined by the patient anatomy.  With submuscular placement the implant can only be placed along the medial (inner) aspect of the muscle insertion.  If the muscle is released to much along the sternum, then you run the risk of implant visibility and symmastia (uniboob).  With placement over the muscle, the surgeon may be able to get the implants closer to the middle, but again there is risk of symmastia and visible rippling/wrinkling.  One potential option would be an implant placement under the muscle combined with fat grafting along the medial breast. This can improve the cleavage in someone with very little breast tissue.  Best to get an in-person exam for optimal information.  Good luck.