Will 465 cc HP saline implants be right for what I want to achieve ? (photos)

Hello,You don't understand or you were not told that the gap between your breasts is less about the size or even the profile of the implant, and more about your anatomy.  Here's your problem: you have no fat or breast tissue covering your sternal area.  Your implants are under your muscle (thankfully!), and to get them or bigger ones 'closer together' would require closing down the outer side of the pockets to push the implants together and dividing the muscle from the sternum, which would lift the pectoralis up off the implant and expose the inner edge of the implant to very thin tissue. In a word, it would be disastrous. Just changing your implants out to larger ones will not necessarily get them closer together either, especially over time, which usually causes them to spread apart, especially in someone with your chest wall shape. The bigger or more high profile the implants, the more they want to drift down and out. You have a nice result and you are at risk for complications with a revision surgery. Choose your surgeon wisely, as experience is crucial to minimizing problems. Additionally, you need to know the limits of any proposed revision. Anybody that tells you that your cleavage can get much closer is probably not telling the truth. Best of luck!

This implant exchange will accomplish your goal of having more upper pole fullness.  It will unfortunately change how far apart the breasts are.  You have an excellent result and the spacing between the breasts is the result of your preoperative anatomy.

A lot of women want to know how to get more cleavage from breast implants. The answer is simple: buy a bra to push the breast tissue closer together. :)When performing breast augmentation under the muscle you have to respect where the muscle begins on the chest bone. The only way to move the implants further together is to completely release the muscle off of the chest bone which leads to symmastia (uniboob) and unnecessarily weakens the chest muscle.The implant size has nothing to do with how close together the implants are on the chest.If you would like more information regarding breast augmentation and the way that I approach this surgery you can download my free breast augmentation planner at aBetterBreast.comI wish you luck with your surgery!

Unfortunately based on your anatomy "a lot of cleavage" and more together isn't possible.  Larger implants will have higher projection and project more laterally.  They will, however, give more upper pole fullness.  As your breasts age, I would be a little concerned with the weight and water hammer effect of a 465 cc smooth saline implant.  You may not support this and find it just becomes a wider looking result with more space over time.  You may consider a textured silicone implant for more stability and support.  Regarding size I tell patients if you want a noticeable change don't be afraid to go 100 cc larger than current.   Adding 135 cc seems like a reasonable increase. 

Thank you for your question and photos.Generally speaking, the best online advice I can give to ladies who are considering revisionary 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. I have found that the use of words such as “natural” or "C or D cup” or "more upper pole" etc 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.
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). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

I agree with most of all of the other surgeons' comments.  I would just like to add that I really do not use saline implants much anymore and I am not sure why they are still used except to save a few dollars in the short run.  They have to be replace more often so they are not more cost effective in the long haul.

Your starting point will be the most important determine as to how well your cleavage will look.  Also be careful with HP implants as they tend to give you great projection, but may not be a good implant choice for cleavage. consider a MPP implant.

Hi I agree with the other Docs here. The implants will give you more volume and a little more lift, but will do little to change the shape or geometry of your breasts. The gap you describe will remain. It can be dangerous to try and correct the natural gap that is caused by the muscle anatomy and width of your sternum. You may wind up with implants that "touch" each other and become ONE elongated breast vs two separate breasts. This condition is called symmastia and can be very difficult to correct. Best to be safe, realistic, and well informed. Best to you on your decision. 

From your photos, it appears that you will benefit from a larger implant to achieve the goals you describe. However, it is impossible to tell you to what extent the changes will be with an increase of 135 cc. Keep in mind that a HP implant will be more narrow than the moderate and the extra width you will achieve will be based upon the extra width provided by the new implant. Also, your anatomy will factor in to how close your breasts can actually be without creating an increased risk for synmastia. You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.Best of luck!

They will look pretty much like you look now, just larger. I know that's not what you want to hear but you need to be realistic.