Wide set boobs - what can be done to make the gap smaller?

Question

Over a year ago I had an over the muscle BA with 345 cc round implants. In hindsight probably the least favourable option for wide set boobs given the tendency to shift a lot. The separation is probably my anatomy but too wide for my liking. I saw a second surgeon who suggested sub pectoral implants with a larger implant achieve the same size as the over muscle implant AND moving the nipple as well- which I don't like. Any suggestions on implants /procedures to make the gap better?

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. A large portion of my practice is dedicated to revision breast surgery. Unfortunately, what happened to you has happened to many women who are told that they can "fill up" the skin envelope and not have a breast lift. Ultimately, the weight the implant continues to drag on the skin envelope, especially if the implants are placed on top of the muscle, and the breasts continue to sag. In your case, you would benefit from a change from subglandular to subpectoral and breast lift. You are an excellent candidate for this. Best wishes to you.

Gary M. Horndeski, MD · Answer

Most likely what has happened is that pre-operatively before your augmentation your breasts were widely separated. The surgeon had to centered the implant underneath the nipple-areola complex and this is wide your implants are wide and to the side. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Reliable241035,
I get this problem all of the time. Typically, its from women who went with high profile implants. This is a problem because while they project more, they are narrow at the base and can have widening effect on cleavage. The second most common problem is incomplete release of the pectoralis muscle medially. Many surgeons don't take the time to make this right. If you're not happy with your results I would suggest you to discuss it with your plastic surgeon. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You can have your outer pockets tightened, so that the implants cannot move as far to the side. The actual base of your breast, however, cannot be moved.

Richard P. Rand, MD, FACS (retired) · Answer

You would like your result better staying under the muscle, not moving the nipples (they don't need a lift), reparing the side pockets so the implants don't fall laterally so much, and using a wider diameter implant to get closer cleavage.

Wide set boobs - what can be done to make the gap smaller?

Answers (5)