Should I bring my breast implants closer together? (Photo)

Question

I have 350 CC high profile silicone implants under the muscle placed two years ago. I’m trying to decide whether or not to place a bigger implant or to stitch my lateral pockets to bring the implants closer. 1 surgeon said he would dissect my medial pocket and stitch the lateral pockets to bring them closer and 2 surgeons told me not to do it. Is there anything I can do to achieve cleavage if I have a wide sternum and am pigeon chested? Would you recommend bringing my pockets in?

Gianfranco Frojo, MD · Answer

I agree with the second surgeon to definitely NOT dissect the medial pocket anymore. This can potentially over released the pectoralis muscle leading to potential animation deformity, symmastia (unibreast), implant malposition, implant visibility, and bizarre fold deformities.  I think that this is a very stable and good looking result. I would recommend really thinking about doing any type of secondary surgery in my professional opinion.

Daniel Barrett, MD · Answer

Dear Awesome531603,
many women seek improved cleavage. Narrowing the cleavage plane can be done very carefully by a skilled surgeon. Moving the implants too far medially can result in synmastia or unaboob which is very difficult to correct. That being said, the right amount of pocket dissection and implant selection can create excellent cleavage. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Yes, you have a wide separation. However, there are variations of what is considered acceptable. Plicating the pocket laterally will help eliminate the lateral displacement. You will also need medial dissection. Another alternative to consider would be fat transfers medially.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Joel Patrick Maier, MD · Answer

Breast augmentation typically enhances your native breast anatomy. It would be very helpful to see your before photos to see if there is any room for improvement. But from what I can see, it looks like your augmentation has a nice result.

Steve Laverson, MD, FACS · Answer

Your ribs are canted laterally and nipple-areola complexes (center of breasts) align near lateral margins of body from front view.  Breasts look nice when standing.  Implants that are slightly wider than your existing centralized a bit superior and medial to your nipples will (like a push up bra) fill out the inner breasts more but you'll not have cleavage without a bra (unless you go disproportionately huge) because of your ribs and native breast anatomy.  Consider fat transfer, or enjoying what you have, which is very nice

Sean Fisher, MD · Answer

starting patient anatomy is a huge factor in considering the final outcome of a breast augmentation, as the implant needs to be placed in relation to where the natural breast is positioned on the chest. In wider chested patients with breasts that are set further apart, it is not truly possible to "medialize" the whole breast as this is set by your anatomy. If implants are positioned in a manner that violates the natural breast boarder, this can result in a poor aesthetic outcome with the nipples being positioned asymmetrically on the implants rather than centrally over the implant. Your implants appear to be in a good position as it relates to your natural breast footprint. 
Sean Fisher Aesthetic Plastic Surgeon

Connie Hiers, MD, FACS · Answer

I would suggest dissecting the one implant that sits a little wide from the sternum in the lower medial part. If you want, the lateral pockets could be tightened some, but you cannot change bone structure. Tighter pockets will make the implants feel firmer.

Mats Hagstrom, MD (license on probation) · Answer

Quality assessment regarding the outcome of any plastic surgery procedure. We need to see a complete set of proper before and after pictures.
If you don’t have before and after pictures and ask your surgeon to forward the pictures they took.
Breast augmentation outcomes are based on three variables.
The first is the patient candidacy for the procedure. The second is implant selection in regards to size shape and type. The third variable is the surgeons ability to put the implant in the correct anatomic location.
 Patient candidacy affected by variables like breast shape, breast position on the chest wall, breast, divergence, etc., etc.
If your breast sit wide on the chest wall, or you have the breast divergence, then that’s the angle of divergence or where your breast sit.
The implant should be centered on each breast.
Plastic surgeons can’t move where your breast is.
Without seeing your before pictures, we can’t have a good understanding of your candidacy for the procedure.
 I’m guessing that your breast sat slightly wide on your chest wall and you had moderate divergence.
I doubt you have a sternum that’s wider than normal people.
It’s probably more likely the position of your breast.
If the implant is put medial and your breast sits lateral then the implant isn’t going to be centered on your breast.
To me, it looks like you were implants are properly centered on your breast, and I suggest accepting your natural breast position and that the implants should be centered and placed where the breast is not where you want your breast to be.
Best,
Mats Hagstrom MD

Should I bring my breast implants closer together? (Photo)

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