Is it possible to get cleavage after your first surgery?

Dear krose8 thank you for your question.
A wide cleavage can be corrected either at the time of implant augmentation or later by applying fat in the subcutaneous tissue. This will give a more round look to the upper pole of the breasts and reduce the distance between them.

Breast implant size selection is important and based on many factors.
The breast implant has three dimensions: height, width and projection. These must be taken into account to help determine a range of sizes which may be best after being examined by a board certified plastic surgeon. Computer imaging (e.g., VECTRA) may help you visualize the simulated results with different breast implants.

Great question!! This is a very common situation where patients have genetically a wide gap between each breast. This is very normal in a certain percentage of the population. If you have a wide gap between your breasts, it will be challenging to bridge that gap without causing a complication known symmastia. You cannot completely get rid of that gap but you can make serious improvements. Another way to make an even better improvement is with fat grafting to the cleavage area which gives a much fuller look and a better result. Subsequent surgeries will not necessarily provide you with improved cleavage so I wouldn't go into the process thinking that a second surgery will make a more significant difference. This would have to be taken on a case-by-case basis.
Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Cleavage all depends on your present anatomy. Breasts vary greatly, including space in between.

If you have a large gap in the center, this will not change after augmentation. Trying to place the implants very close together may distort the nipples and breasts towards the sides.

Breast implants will usually enlarge fullness of the inner breasts, better cleavage, again, limited by your body.

Breast implants will enhance, your specific questions are best discussed during consultation with a plastic surgeon.

Hi & thanks for your question!
It depends on your frame and position of breasts. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

It is natural to have some spacing between each breast. This space is overlying the sternum and plays an important role in the aesthetics of the breast. If this space is dissected and the breast implants placed too medial, the patient will have the unfortunate complication of symmastia. This being said If the breast implants are placed too lateral, there will be too large of a gap which is likely what you are referring to. If the breast implant pocket is appropriately dissected, and the proper implant size is selected, it will be easy for a patient to have an aesthetically pleasing cleavage area in a well selected bra and top. Breast augmentation is a common surgery that we do in our practice. Please see the attached link for more information on this topic.

Great question! Yes, it is possible to minimize the gap in the first operation, though how much will depend on your own anatomy and the type of procedure. The "gap" is dependent on a couple of things, mostly how wide apart your breasts and pectoralis muscles are. For under the muscle breast augmentation, you can only get as close as the muscles will allow (you don't want to detach the pec muscles!). For subfascial breast augmentation, you can get a little closer but are still limited by the fascia over the muscles. To get any closer, you need fat grafting which can be done at the time of the first procedure, but sometimes another round may be needed or wanted later.

Can't build cleavage, but the good news is, regardless of placement and shape/profile, you will have more volume or size. This fact will make it easier to create cleavage in clothes. It's often a possibility of developing a "uniboob" when surgeons try to "close" the gap between the breasts. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Formation of the cleavage depends of several factors; insertion of the pec. muscle on the chest bone, shape of the breast tissue and it's position on the chest wall, position of the ribs, etc. For that reason, even with best efforts, it may not be possible to create cleavage on every patient seeking breast augmentation with implants. You should discuss this issue with your surgeon ahead of surgery. Good luck.

Dear krose8,
many women seek improved cleavage. Narrowing the cleavage plane can be done very carefully by a skilled surgeon. Moving the implants too far medially can result in symmastia or unaboob which is very difficult to correct. That being said, the right amount of pocket dissection and implant selection can create excellent cleavage. Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery