Are my implants placed too far apart? Do my breast look mishaped? Are my implants uneven? (Photo)

I'm 5'3, 129lbs, 30 yrs old. I had my augmentation done exactly a year ago. Under the muscle, 450cc, silicon implants. I was pretty flat to begin with. I asked my surgeon for a natural looking size (a size that fit my body). My implants feel like they're always to the sides of my chest. When I lie down they go all the way out to the side. I feel like my chest is still flat and my implants are located on the side. I can't get cleavage from a bra and I don't know if that's normal.

Doctor Answers 6

Breast Implants

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It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

Are my implants placed too far apart? Do my breast look mishaped? Are my implants uneven

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Thank you for your question. without seeing prop pictures, can not comment. Look like you have some asymmetry, may be there before surgery itself. Please express your concern to your PS.

Breast Asymmetry

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Without pre-op photos it is very difficult to answer your question.  Cleavage is determined by you and your anatomy. It sounds as though the pocket created for your implant may be to large, causing your implants to slide into your armpit when you lay down.

If you are unhappy with your results, I would seek advice from a Board Certified Plastic Surgeon in your area. They should meet with you in person to go over your concerns and come up with options for correction if warranted.

Good Luck!

Are my implants placed too far apart? Do my breast look mishaped? Are my implants uneven?

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Without pre-op photos - it's difficult to comment accurately. It appears that there may be some degree of pre-op asymmetry which may not be correctable with implants alone. It's difficult to get good cleavage with sub-musculr implant placement unless great care is taken to create the pocket as close to the breast bone as possible.

Breast augmentation

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Thank you for your question and photos.  Without photos of your breasts prior to surgery, it is difficult to assess your results.  Keep in mind that your anatomy prior to surgery will dictate aspects of your result.  For example, the distance between your breasts cannot be made shorter as this will cause your nipples to migrate to the sides of your implants, distorting the appearance of your breasts.  If you are dissatisfied with your results, you should contact your operating surgeon to determine what, if anything, can be done for your case.

Best of luck!


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Placing implants under the muscle is a compromise.  There are no breasts located under the muscle in nature. 

Two anomalies can occur with implants under the muscle, depending on your original anatomy.

1)  jumping breast deformity.

The muscle is cut inferior medially to insert the implant under the muscle. The muscle retracts and adheres to the breast tissue above. When you flex, the breast is pulled out instead of pulling the arm in.

2) wide cleavage

The implant cannot go past the medial (sternal) attachments of the muscle. As the implant size increases, it migrates toward the axillary line (lateral fullness).  Patients with wide insertion of the muscle to start with, end up with wide cleavage.  If they have enough natural breast tissue to push together in a bra, they may get a classical tube deformity as the breasts touch but the cleavage base won't come together.

Your result is very respectable in the relaxed position.  I suspect your concerns are the trade off of going under the muscle.

Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 11 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.