Broad shoulders w/ wide set breasts, can augmentation give me cleavage or will I still have spaced breasts? (photos)

Question

I have broad shoulders and breasts that are wide set (3” between them arms raised, about 2” with arms down). I wear a 36C but look like a small B nude. I’m 5’9” fluctuate between 155-170 lbs, 1 child + nursed for 14 months. Can I achieve larger, full breasts that sit close together with natural cleavage like in the goal photo? I don’t care about projection- I just want them full with a natural shape and closer together with cleavage.

John L. Burns Jr., MD · Answer

I would design your implant pocket medially by limiting the lateral dissection at the anterior axillary line and making more space in the superior and medial part of the breast.

Christopher J. Davidson, MD, FACS · Answer

Thank you for your photograph and question.  Your plastic surgeon is limited regarding implant placement with regard to your own anatomy.  That being said, the larger the implant, the larger the "footprint" or base.  My advice is to seek an in-person consultation with a board certified plastic surgeon.  During your consultation measurements will be taken and you will have the opportunity to try on implants and view computer imaging if available to determine what best suits your particular circumstances.  Good luck.

Eric YK Li, MD · Answer

In general, a patient's baseline anatomy is the limiting factor as to what can be achieved after a breast augmentation.  While implants can improve cleavage somewhat from the added volume to the breasts alone, it would be risky to dissect a breast pocket extending medially in the hopes of creating more cleavage. The tissues there are very thin and the implant may become palpable and visible, and over-dissection can also create a "uniboob" situation (something we call symmastia) that is both problematic in appearance and difficult to fix.
With recent developments in aesthetic breast surgery it is possible to try to improve cleavage with targeted fat grafting involving the medial poles of the breasts.  This wouldn't have the same disadvantages as above and is certainly a reasonable thing to try.  I would encourage you discuss this with your surgeon.  As always, seek proper consultation before treatment and best of luck!

Tom J. Pousti, MD · Answer

Thank you for the question.  Generally speaking, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery. More specifically, every patient's anatomic starting point will to some degree determine how much space will be present between the breasts after breast augmentation surgery.  Other factors involved include careful breast implant pocket dissection and careful selection of breast implant size/profile.  Remember (when it comes to breast implant pocket dissection and achievement of ideal breast implant cleavage) that each nipple/areola complex must be centered on each breast mound.
Ultimately, careful selection of plastic surgeon and 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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering 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 “full with natural shape” 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.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Jeremy B. White, MD · Answer

Hi Eden! I agree that your breasts are set apart widely. Breast augmentation with a breast implant will help to improve your cleavage partially, but there are limitations regarding how close together the surgeon can bring the breasts safely due to insertion points of your chest muscle and concern for developing a "uniboob," which is not a good look :) Bottom line, the surgeon has to work with the space that you have and you have to understand the limitations in cleavage improvement. This can be discussed and explained further after an in person examination and consultation.

Robert H. Hunsaker, MD · Answer

You would have a LOT of noticeable improvement in your cleavage, but perhaps not quite like the photo. A better answer could be given after an exam to evaluate the tissue characteristics.

Broad shoulders w/ wide set breasts, can augmentation give me cleavage or will I still have spaced breasts? (photos)

Answers (6)

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