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Can anything be done to fix this gap in between my implants or improve my cleavage? (photos)

I wanted a natural looking augmentation with small implants but I am not happy with my result. I had mentor silicone gel implants 250cc's in right breast and 275ccs in left breast moderate plus profile. When I wear low cut clothing it looks like I'm still flat chested from the front. They also stick out on the side. I was happy the first weeks but when the swelling went down the cleavage disappeared. Even when I was an A I had a little cleavage and now it's flat. What can I do?

Doctor Answers 8

Minimal Cleavage After Breast Augmentation

May 5th, 2016
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Thank you for your question and for the photos which really help to show where you are at now and what you are looking for. I don't think you mentioned how far you are out from your surgery.  If you are still within the first three months, then displacement exercises (breast massage) may help to decrease the gap between your breasts.  In addition, assuming the implants are below the muscle, more time should allow the pectoralis muscle to relax and the cleavage to improve. The skin will relax as well as time passes. 
However, if time and breast massage don't help, there are still things that can be done to achieve your desired result.  However, they will probably require additional surgery.  You could switch to larger implants as well as undergoing some additional dissection along the medial aspect of the implant pockets.  By this I mean along the sternum.  Of course, over dissecting this area could lead to complications such as rippling or even symmastia (Uniboob).  Moving the implants to a location above the muscle would be a consideration as well, although I rarely use that technique.
I would suggest you discuss your concerns with your plastic surgeon.  Show him or her what you were hoping to achieve and get his or her feedback.  If necessary, consider a consultation with another board certified PS in your area to get a fresh perspective.  Best of luck. 

Web reference: http://www.drweider.com/breast-implants-dallas/

Laurence Weider, MD
May 5th, 2016

Minimal Cleavage After Breast Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question and for the photos which really help to show where you are at now and what you are looking for. I don't think you mentioned how far you are out from your surgery.  If you are still within the first three months, then displacement exercises (breast massage) may help to decrease the gap between your breasts.  In addition, assuming the implants are below the muscle, more time should allow the pectoralis muscle to relax and the cleavage to improve. The skin will relax as well as time passes. 
However, if time and breast massage don't help, there are still things that can be done to achieve your desired result.  However, they will probably require additional surgery.  You could switch to larger implants as well as undergoing some additional dissection along the medial aspect of the implant pockets.  By this I mean along the sternum.  Of course, over dissecting this area could lead to complications such as rippling or even symmastia (Uniboob).  Moving the implants to a location above the muscle would be a consideration as well, although I rarely use that technique.
I would suggest you discuss your concerns with your plastic surgeon.  Show him or her what you were hoping to achieve and get his or her feedback.  If necessary, consider a consultation with another board certified PS in your area to get a fresh perspective.  Best of luck. 

Learn more: http://www.drweider.com/breast-implants-dallas/

Laurence Weider, MD

Small implants with cleavage

May 22nd, 2016
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As many of the other PSs have mentioned, your anatomy is going to be the limiting factor. You are quite slender, so above the muscle implants are going to have a significant rippling risk. If the implants remain under the muscle, your pec attachment to the breast bone is going to limit how close together they can be. 

That being said, you have implants on the smaller side and you liked them initially with post-op swelling. Increasing the size of the implants with medial and superior capsulotomies (open the implant space toward the middle and upper portion, but not make any extra room to the side or bottom) will improve the cleavage. I would also recommend using the same implants on both sides, it is pretty obvious in the picture that the left breast has the larger implant. 

Best of luck!

Web reference: http://bradleyhubbardmd.com

Bradley A. Hubbard, MD
May 22nd, 2016

Small implants with cleavage

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
As many of the other PSs have mentioned, your anatomy is going to be the limiting factor. You are quite slender, so above the muscle implants are going to have a significant rippling risk. If the implants remain under the muscle, your pec attachment to the breast bone is going to limit how close together they can be. 

That being said, you have implants on the smaller side and you liked them initially with post-op swelling. Increasing the size of the implants with medial and superior capsulotomies (open the implant space toward the middle and upper portion, but not make any extra room to the side or bottom) will improve the cleavage. I would also recommend using the same implants on both sides, it is pretty obvious in the picture that the left breast has the larger implant. 

Best of luck!

Learn more: http://bradleyhubbardmd.com

Bradley A. Hubbard, MD

For cleavage implants need to be in front of muscle

May 5th, 2016
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Lack of cleavage is universal complaint with submuscular implants.  Muscle attachments to sterum keep cleavage of breasts apart. 
Vasdev Rai, MD

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

May 5th, 2016

For cleavage implants need to be in front of muscle

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Lack of cleavage is universal complaint with submuscular implants.  Muscle attachments to sterum keep cleavage of breasts apart. 
Vasdev Rai, MD

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Lack of cleavage

May 5th, 2016
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Sorry to hear that you are not happy with your results. I would like to know if your implants were above or below the muscle. Also, not quite sure how far out of surgery you are. At the 3-6 month mark, it would be reasonable to consider implant revision. Placing slightly larger implants above the muscle and slightly narrowing the space between the breast may be an option. I am quite sure that if you looked at your before pictures the distance between your breasts were likely the same. Surgically narrowing the cleavage distance can result in a condition known as symmastia which can be quite difficult to correct later. I recommend talking with your plastic surgeon and discuss these issues with him or her first.


Best wishes,
Dr. Ravi Somayazula

Web reference: http://www.bodybyravi.com/before-after-photos-houston/breast-augmentation/

Ravi Somayazula, DO
May 5th, 2016

Lack of cleavage

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Sorry to hear that you are not happy with your results. I would like to know if your implants were above or below the muscle. Also, not quite sure how far out of surgery you are. At the 3-6 month mark, it would be reasonable to consider implant revision. Placing slightly larger implants above the muscle and slightly narrowing the space between the breast may be an option. I am quite sure that if you looked at your before pictures the distance between your breasts were likely the same. Surgically narrowing the cleavage distance can result in a condition known as symmastia which can be quite difficult to correct later. I recommend talking with your plastic surgeon and discuss these issues with him or her first.


Best wishes,
Dr. Ravi Somayazula

Learn more: http://www.bodybyravi.com/before-after-photos-houston/breast-augmentation/

Ravi Somayazula, DO

Can anything be done to fix this gap in between my implants or improve my cleavage?

May 5th, 2016
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Thank you for your question.  If you're at least 3-6 months postop and not satisfied with your results, you may certainly consider revision implant surgery.  In this case, your implant pocket would be revised, bringing the implant closer to the midline.  Also, larger implants may be considered.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Web reference: http://www.farrismd.com/breast-procedures-dallas/breast-augmentation/

Zachary Farris, MD, FACS
May 5th, 2016

Can anything be done to fix this gap in between my implants or improve my cleavage?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question.  If you're at least 3-6 months postop and not satisfied with your results, you may certainly consider revision implant surgery.  In this case, your implant pocket would be revised, bringing the implant closer to the midline.  Also, larger implants may be considered.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Learn more: http://www.farrismd.com/breast-procedures-dallas/breast-augmentation/

Zachary Farris, MD, FACS

Can anything be done to fix this gap in between my implants or improve my cleavage?

May 4th, 2016
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Ask your surgeon about breast implant displacement exercises and pushing the breast implants together towards the cleavage area.After your implants drop (2-3 months) they should become softer, more moveable and move into the cleavage with a supportive bijini top. Your initial photo looks quite good.

Web reference: http://www.bostonplasticsurgeryspecialists.com/services/breast-surgery/breast-augmentation/

Brooke R. Seckel, MD, FACS
May 4th, 2016

Can anything be done to fix this gap in between my implants or improve my cleavage?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Ask your surgeon about breast implant displacement exercises and pushing the breast implants together towards the cleavage area.After your implants drop (2-3 months) they should become softer, more moveable and move into the cleavage with a supportive bijini top. Your initial photo looks quite good.

Learn more: http://www.bostonplasticsurgeryspecialists.com/services/breast-surgery/breast-augmentation/

Brooke R. Seckel, MD, FACS

Anatomy determines

May 5th, 2016
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unfortunately, your anatomy is going to determine where the implants need to be placed.  in your case, your nipples appear too wide to provide you with significant cleavage.  you have to center the implants on native nipple and areolar complexes.  otherwise, a mastopecy is necessary. 
Ethan Philpott, MD

Ethan Philpott, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

May 5th, 2016

Anatomy determines

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
unfortunately, your anatomy is going to determine where the implants need to be placed.  in your case, your nipples appear too wide to provide you with significant cleavage.  you have to center the implants on native nipple and areolar complexes.  otherwise, a mastopecy is necessary. 
Ethan Philpott, MD

Ethan Philpott, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

What Can Be Done to Fix the Gap Between my Breast Implants

May 4th, 2016
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Thank you for your question.  I am sorry you are not happy with your results.  First, speak to your surgeon, there may be some exercises and support garments that may help to better position your implants.  Also, a period of just waiting may be a consideration to allow the implants to settle.  In regards to surgical interventions to improve your cleavage, there are several options, which may include fat grafting to the cleavage area or exchanging the implants and creating a new pocket.  In some cases, it may not be realistic or safe to modify the medial portion of the breast.  Ultimately, the implant size is dictated by your breast anatomy.

I hope this helps.


Good Evening,
Nicholas Jones, MD

Nicholas Jones, MD
Charleston General Surgeon
5.0 out of 5 stars 1 review

May 4th, 2016

What Can Be Done to Fix the Gap Between my Breast Implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question.  I am sorry you are not happy with your results.  First, speak to your surgeon, there may be some exercises and support garments that may help to better position your implants.  Also, a period of just waiting may be a consideration to allow the implants to settle.  In regards to surgical interventions to improve your cleavage, there are several options, which may include fat grafting to the cleavage area or exchanging the implants and creating a new pocket.  In some cases, it may not be realistic or safe to modify the medial portion of the breast.  Ultimately, the implant size is dictated by your breast anatomy.

I hope this helps.


Good Evening,

Nicholas Jones, MD
Charleston General Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.