Disappointed with Size & Gap, Should I Upsize Since I Need Revision Surgery Anyway, or Too Risky? (photo)

6 mnths ago I got 300cc, round, smooth, silicone implants 12 cm subpec. Pre op BWD 12.2cm left & 13cm right. I have distortion when flex. My breasts seem a bit small, but mainly the cleavage gap is too wide. Thought I'd have gap like when I breastfed. Push up bra doesn't help - pecs too strong? Left side bottomed out (maybe pec pushed it down) and I need revision surgery. Should I get wider/larger implants? What size would be good for a bigger but NATURAL look? Fix pecs? I'm fit 110 pnds 5ft2

Doctor Answers 9

Implants in Widely Spaced Breasts Will Not Make Cleavage

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Short of absurdly large breast implants, it is not going to be possible nor advised for you to your breast implants any closer than they are now. You had widely spaced breasts initially and obtaining cleavage with implants was not realistic. You can have some size increase and the implant malposition fixed but expectinjg better cleavage should not be the reason you undergo any revisional breast implant surgery.

Breast augmentation size and breast gap

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Thanks for your question and pictures.You bring up a few different things you are concerned about.  

First, the breast size.  This can only be changed by different size implants.  

Your second concern is the cleavage gap.   The "footprint" of you breast is where it sits on your chest wall.  This cannot be changed significantly with regard to the distance between your breasts.  This is where your breasts sit, implants simply "augment" the breasts.  Getting wider implants is not going to close down the distance between the breasts. Rather, they will fill out laterally, making the breast wider and larger out towards the armpit.  


Lastly, you do have some bottoming out on the left side, fixing this will make them more symmetric.  Choosing the size of the implant is ultimately up to you and your surgeon, as a "natural" look can vary person to person.  


Good luck!

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 37 reviews

Bottomed out implant

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Agree with the other docs here. Your gap was wide to begin with. It can be dangerous to try and close that gap any more. Remember, everyone is made differently. Some have a wide sternum some don't. Any attempt to further narrow the gap would risk a symmastia ( you don't want that!) where there is no cleavage but the two implants touch each other. 

question: during your consultation, did you have the opportunity to try on several different sizes? How did you pick the 300? Was there concern that you didn't want to be bigger at that time? 

It's not too risky, but remember that any surgery carries risks. Also, important to not exercise too early after surgery. the pect is very strong and can push down or rip the sutures he/she will be placing to correct the bottoming out. 


Bennett Yang, MD Washington DC 

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Implant issues

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You may want wider implants and and possibly correction of your bottoming out issue as well. Good luck with your decision.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Wide Gap and Bottoming Out

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   The gap looks to be as well managed as possible.  The bottoming out can be fixed with capsulorrhaphy.  Kenneth Hughes, MD Los Angeles, CA

Disappointed with Size & Gap

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looks like your surgeon did quite a bit to minimize the gap, and I am not sure much more can be safely done. Your breasts before surgery are quite widely separated, and that makes cleavage unlikely. With widely spaced breasts, the pec muscles are also further from the midline, and that limits options in positioning a sub-muscular implant. 

When implants are under the muscle, the implant will be flattened when the pectoral muscles are flexed. This is more noticeable in some women than in others, and often asymmetric due to a stronger pec muscle on the dominant side. 

It does make sense to fix the bottoming out. Use larger implants only if you want to be larger. But they may actually accentuate the gap that you don't like.

Discuss at length with your surgeon before undergoing your revision procedure. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon


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The larger your implants become the less natural you will look. Breast implants can not create cleavage. This is made by a bra

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Improving Cleavage Area and Bottoming Out after Breast Surgery?

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Thank you for the question and pictures.

After reviewing your stated goals and pictures, I think you may benefit from a modestly larger breast implant size/width to improve the cleavage area.  This should be done very carefully in order to avoid complications such as breast implant malposition.

 The inferior breast implant displacement can be corrected using internal sutures ( capsulorrhaphy).

 When the time is right, seek consultation with board certified plastic surgeons who can demonstrate significant experience helping patients with revisionary breast surgery. Communicate your goals clearly;  the use of all pictures are very helpful.

 Best wishes.

Too much space between breasts after augmentation

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is usually a reflection of what you started with.  Implants only increase the size of what you start with.  If you pushed the issue of wider implants, your nipples would rotate laterally as your implant moved medially.  Personally, I think your results are quite good and unless it was extremely important to you, to enjoy your new look. 

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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.