Internal Sutures Vs. Wider Implant for Closer Cleavage

I've been to two different surgeons who have both aknowledged the wide space between my breasts. One surgeon suggests internal sutures, but the other suggests a wider implant. what should I do?

Doctor Answers 13

Cleavage and its pursuit...

Hi there-

This is going to be a difficult question to answer without examining you, but generally speaking...

Breast implants should be chosen to fit the individual patient's anatomy. Poor decision making is one cause of poor cleavage.

If your implants are too narrow, the pocket is too lateral, or your anatomy dictates, you will have a large gap between your breasts.

The very best advice I can give you is this- do not spend any more time thinking about or researching the technique for improving this-

Rather, use your energy and time educating yourself about the SURGEONS available to correct it for you.

Find a surgeon with a great deal of experience in breast surgery- one who can show you beautiful examples of his/her work. And then trust them to "do what they do best" without second-guessing their recommendation.

Want more help finding such a surgeon? Please read this:

Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Internal Sutures Vs. Wider Implant for Closer Cleavage

I am unclear where the "internal sutures" would be utilized to create closer cleavage. In general, the principle is to correctly pick the ideal implant for you based on your desires and your anatomy. Make sure to work with a board-certified plastic surgeon, and if you have continued concerns, then you are free to seek extra opinions. Wishing you the best.

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 11 reviews

Internal Sutures Vs. Wider Implant for Closer Cleavage

I am a little confused and do not understand how internal sutures create cleavage by do understand how a wider implant would accomplish this so  I would favor the latter approach.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

How to fix a wide area between your breasts

You can go either way...wider implants or internal sutures.  The result may last longer and look more natural with wider implants as the implants are almost identical and suture may break or scar differently.  Without photos, it's hard to tell you exactly the way to go.  With wider implants, you may not have to be huge, just a little larger than you initially thought.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 201 reviews

Internal sutures vs. wider implant for closer cleavage

Neither! If you have not had surgery and your tissue to non operated upon than have a smaller pocket dissected more to the medial. If you already had surgery in the past than internal suture in the medial sternal area would be the only try I would recommend. Best of Luck


Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

It depends on the width of your chest wall

If you are happy with the lateral appearance of your breasts, then consider wider implants to create more cleavage.  If your lateral breasts are not appealing to you, then you probably need internal suturing with or without a release of the chest muscle to create more cleavage.  Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

Wide cleavage

Anatomy is our destiny. If you do not have any cleavage before surgery, you should get some improvement with surgery, but it will not correct for a very wide chest. If you force it over, you may develop a symmastia.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Wide Breasts and Implants

In reality, what causes the breasts to be farther apart is usually the sternum.  If you have a broad sternum, then you cannot really alter this in a predictable manner.  The implants have to sit centered on your nipple areola complex, so if the nipples are farther apart or off to the sides, then the implants will be farther apart as well.  If you try and move the implants closer together by dissecting the medial area, this can weaken the tissues too much and lead to complications such as symmastia.  I am not sure where the internal sutures would apply in a primary augmentation.  These are usually for repairing the medial area when the pocket is to big already.  I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 73 reviews

Placing a textured silicone gel implant in a new pocket whether is usually better to reposition the breast

There are many reasons that breast implants appear too far apart after breast augmentation. A wide sternum (breast bone) is one reason that can not be corrected. A pocket that is too large and the implants fall out toward the arm pit can be corrected with sutures but frequently these do no hold. A better approach in my hands is to create a new pocket for the implant that is in the appropriate position and use textured silicone gel implants. These tend to stay where they are placed and prevent the falling out of the implants.

Another cause of this problem is that the surgeon made the pocket too lateral. This may have been inadvertent or intensional because your nipple areolar complex was more lateral. If this is the case to move the implants medially will make your nipples look out to the side. Best this for this is a push up bra. Some times with smooth wall saline implants under the muscle the patient does not message the implants properly. They fail to make the implant go medially and the pocket closes off. The solution for this is to reopen the pocket medially and message the implant medially to keep the pocket open while the wounds heal. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

Wide Space between Breasts

Without a picture or examining you or knowing your surgical history, it is difficult to give you specific advice.  However, it is most likely that you would need a combination of internal sutures laterally and a wider implant.  However, you also may have anatomy that makes it difficult or impossible to achieve the result that you want.  That is why it is very important that you discuss the procedure with your surgeon to determine if what is surgically possible meets your expectations.  Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 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.