I Would Like Cleavage but Have a Wide Sternum - Will I Get Cleavage with 300cc Silicone Overs or is 350cc Better?

If you have breasts that are placed wide apart, a good bra is the best way to create cleavage after a breast augmentation.  Trying to place implants closer together or choosing excessively large implants just to have better cleavage will leave you wishing you didn't do that.

for an augmented breast to look good, the implant should be placed in such a way that the nipple will become the most prominent part of it.  In the case of the round implants, it means the implant should be centred behind the nipple.  In the case of shaped implants, the most prominent portion of the implant should be right behind the nipple.  However if the implants were place closer together in a patient with a wide space between natural breasts, then yes, a cleavage could be created but the natural breast tissue would be falling off the side of the implant and point out laterally.  Not a pretty sight.

Sincerely,

Martin Jugenburg, MD

When implants are placed under the muscle, the cleavage line tends to stay in a similar position. It's possible to thin the muscle slightly during surgery and this helps create closer cleavage. However, the muscle should not be released completely. This can cause problems that are difficult to fix. Another option is to use fat grafting on the inner cleavage to bring the cleavage line closer together. Speak with your surgeon about their thoughts regarding how best to give you the look that you desire.

It’s not unusual for patients to have specific aesthetic
goals for size, contour, and cleavage following breast augmentation surgery. Unfortunately
these aesthetic goals aren’t always easily accomplished and for this reason
comprises may occasionally be necessary. This is frequently the case when
patients are concerned about cleavage following surgery.Poor cleavage can occur for a variety of reasons. In the
majority of cases, inadequate cleavage is related to anatomic considerations.
These include abnormalities of the chest wall, abnormalities of breast contour,
and abnormalities of nipple areola position.Unfortunately your pictures suggest significant lateral
malposition of your nipple areola complexes. This places limitations on the
amount of cleavage that can be obtained with breast augmentation surgery.Increasing the size of the breast implant probably won’t
significantly alter cleavage for several reasons. It’s important to center the
implant directly beneath the nipple areola complex. In an effort to improve
cleavage, implants with wider base dimensions are occasionally used. When these
implants are centered beneath the nipple areola they move the breast laterally
and medially. When patients have laterally positioned nipple areolas, this
results in the breasts protruding in an outward direction to the side.Efforts to create cleavage by moving the entire implant
is an inward direction can result in malposition of the nipple areola complex.
In these cases, the nipple areola would look as if it were sitting the side of
the breasts.Increased breast implant size may not always be the
solution for poor cleavage. If you’re considering breast augmentation and
cleavage is one of your primary aesthetic goals, it’s important to discuss this
issue with your plastic surgeon. Your surgeon should be able to perform a
physical examination and discuss any limitations that might be imposed by your
unique anatomy.

Post-operative cleavage will depend on your pre-surgery cleavage. You have wide-set breasts, which means you'll probably continue to have wide-set breasts after surgery. However, while you may have a bit of improvement, it may not be as much as you want. Unfortunately, your surgeon can only do so much to give you cleavage before it looks abnormal, since the implants have to remain centred underneath your nipples.  

Breast augmentation does not necessarily give you cleavage. Some people have breasts which are naturally closer together and will have more cleavage after breast implants are placed.  Based on your photos I feel it will be difficult for you to have cleavage after breast augmentation, although your breasts will be closer together.  You appear to be thin with minimal breast tissue so I would also recommend silicone implants to reduce the chance of rippling (compared to saline implants).

Cleavage is best obtained with the use of a good bra.

Best wishes,

Dr. Bruno

Very common question. The answer is not what patients want to hear. A wide sternum is an anatomic condition. You were born with it and there is not much you can do to solve the problem. If a surgeon tries to put the implants closer together, it will distort the appearance of the breast and since there are no natural fold or separations in the sternum, you are at risk for synmastia (loss of claevage) "unaboob". Not pretty, difficult to fix. Remeber everyone's body is shaped differently. Celebrate your uniqueness. Good luck.

I would be very reluctant to put implants over the muscle in an individual with your thin body habitus. However, I would encourage you to consider the 350cc moderate plus under the muscle.

You will have more cleavage with implants, and your surgeon can help you achieve this. However, because of your naturally wide spaced breasts, your breasts will remain somewhat spaced far apart after surgery as well. 

It is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

The size of your implants will not determine cleavage.the making of the pocket will determine this and it is a judgment call on the part of the surgeon just how close you can make the pocket so size is not that critical.