Why Do Someone Women Have Large Gaps After Breast Implants?

Almost every patient says to me that they don't want the wide gap between their breasts. Rarely, if ever, is the problem due to the surgeon simply placing the implants too wide.
It is almost invariably due to some combination of : a prominent breast bone that somewhat sticks forward, a rib cage that is angled in such a way that the breasts point out to the sides rather than straight ahead, and very little fat overlying the breast bone.
The biggest mistake surgeons and patients make is thinking that a larger implant will help the situation. In fact, the opposite is usually true. A breast implant will never sit atop the breast bone; an implant does not in and of itself create cleavage where there is no natural soft tissue. So when going ever larger, it just makes the breasts seem disproportionately large relative to the gap, which emphasizest he gap. The best thing to do if a patient has this sort of configuration is to avoid overly augmenting the breasts, so that the widish gap does not look odd relative to very large breasts.
The surgeon evaluating you should be able to tell you whether you are or are not at risk for having this type of appearance.
Hope that helps.

Thank you for your question. This condition usually arises from poor choice of implant and inadequate submuscular dissection. By further dissection and appropriate use of a broader based implant this condition can be improved. Please note that some women are prone to having this issue as a result of the poor curvature of their chest wall. Hope this was helpful, best of luck!Dhaval M. PatelDouble board certifiedPlastic surgeonHoffman EstatesBarringtonOakbrookChicago

Thank you for your question.  The amount of cleavage a patient can expect after a breast augmentation procedure really depends on the anatomical shape, breast height and boarders of their natural breasts.  Most specifically and most crucial is where the medial boarder of the breasts lies and in some women it can be super close and in others fairly wide.  The distance between a patients' natural breasts cannot be changed.  Creating a breast pocket that extends past the boarders of a patients natural breast can create symmastia or a mono-breast or breast implants that fall too laterally and into the patients underarm region.  It is for these reasons in a patient with naturally wide-set breasts that 'good' cleavage may only be found in a good push-up bra.  I hope this helps!

It’s not unusual for patients to have specific aesthetic
goals for size, contour, and cleavage following breast augmentation surgery.
Unfortunately these aesthetic goals aren’t always easily accomplished and for
this reason compromises may occasionally be necessary. This is frequently the
case when patients are concerned about cleavage following surgery.

Poor cleavage can occur for a variety of reasons. In
rare cases, poor cleavage may be related to technical considerations. Examples
might include too much lateral breast pocket dissection or inadequate medial
pocket dissection. In other cases it might be related to the usage of implants
that have inadequate base width.

In the majority of cases, inadequate cleavage is related
to anatomic considerations. These include lateral sloping chest walls, the
breast shape, and lateral positioning of the nipple areola complexes. It’s
important to center the implant beneath the nipple areola complex. Efforts to
create cleavage by moving the implant in an inward direction can result in
malposition of the nipple areola. In these cases, the nipple areola would look
as if it’s sitting on the side of the breast.

If you’re considering breast augmentation and cleavage
is one of your primary aesthetic goals, it’s important to discuss this issue
with your plastic surgeon. Your surgeon should be able to perform an
examination and discuss any limitations imposed by your unique anatomy. 

Why Do Someone Women Have Large Gaps After Breast Implants? Some reasons listed below:


widely spaced breast mounds

widely spaced nipples

small diameter breast implants relative to breast diameter

pectus carinatum

incomplete pectoralis release

pectoralis strengthening/exercises

excessive lateral pocket dissection.

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There is a dynamic interaction between hard tissues, (chest wall, sternum, etc), soft tissues, (the breast tissue), and the implants themselves.  Often the surgeon will aggressively dissect out the mid-line between the breasts, but the body will pull the implants apart. 

During the consultation, review with your doctor your particular anatomy.  Is your chest like a bird or a valley?  How far apart and what shape are your breasts now?  Together you can then make the best plan to reach your goal and avoid things that you don't want.

Patients with a rounder rib cage often have breasts that naturally lie or point outwards. The width of the breastbone may vary as well, and smaller or narrower breasts will have more space between them.
Keep in mind that your surgeon can "remodel the house" and make your breasts fuller, but not "move the whole house" to a new place on the hill!

Hi there-
There are several things that can lead to an unnatural gap between breast implants and poor cleavage:
Patient anatomy- there are definitely some (but very few) women in whom the creation of lovely cleavage is not possible because of the shape of their chest wall and/or the insertion point of their chest muscles.
Poor implant pocket creation at the time of surgery.
Poor choice of implant. This is BY FAR the most common issue in patients I see for correction of unsatisfactory results from prior surgery elsewhere.
How can you avoid this problem? Choose a surgeon wisely, and never based on price. You WILL get what you pay for- pay a little, get a little... With regard to choosing a surgeon, you should read this:
http://orlandoplasticsurgery.blogspot.com/2009/11/choosing-plastic-surgeon-part-2.html#f550
Also, make sure you understand the following:
tp://www.realself.com/article/achieving-beautiful-breasts

There are two main reasons for gaps between the breasts after implant placement. The first is the patient's anatomy. If the breasts are wide apart to start with, then after the implants are placed, the width may appear larger. Second, is the implant placement. If the implant is placed to laterally (far apart), then the breasts may appear to have a large gap between them.

It is truly remarkable how common a problem the wide gap after augmentation is, at least in the on-line B&A picture sets. There are a number of causes. Sometimes large implants above the muscle are not well supported and drift apart over time.
Under muscle implants have a different problem, which is that the muscle attaches along the edge of the breastbone (sternum) so that pushes the implants apart every time the muscle flexes.
The surgery is often a balancing act in that the muscle needs to be released enough to let the implants come close together, but if the muscle is completely detached then a much worse problem sets in. Probably the most important thing is to get the diameter of the implants right.