No cleavage after implants. Will this settle on its own or should I consider fat grafting? (Photo)

The separation of the implants is something that can likely be corrected, however an in person physical exam would need to be done to determine exactly what would work best. Fat grafting is likely not the best answer as it will not provide enough bulk in that area to provide the volume you are looking for. Any revision to make the implants closer surgically speaking will have to avoid making them too close, as breast implants that touch in the middle (symmastia) is one of the most difficult problems to fix in breast surgery.

Fat grafting can be very effective for correcting cleavage provided that you have sufficient fat
Newer techniques are giving longer lasting results.

The appearance of the cleavage gap after a double mastectomy with immediate reconstruction can be influenced by various factors, including surgical techniques, implant size, and individual anatomy. In some cases, the tissues need time to settle, and the appearance may change during the recovery process.

It’s important to discuss your concerns with your reconstructive surgeon. They can assess your current situation, provide insights into whether the gap may improve with time, or discuss potential options like fat grafting to address any asymmetry or gaps.

Best of luck !