Just get breast implants or would a fat graft be necessary for breasts to have more upper pole fullness and be closer? (Photos)

Question

I’m 5’1 and 19 years old. I’m currently a 38dd and bottom heavy. I don’t have loose skin but I feel most of my volume sits lower and towards the side. My biggest concern is the spacing, I feel like my breasts sit too far apart. I’d like more upper pole fullness and a closer, fuller look while still staying proportional to my frame. Would implants alone achieve this, or would a fat graft or lift be necessary?

Daniel Barrett, MD · Answer

Dear AllySaphirre12,

tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.
The type of surgery best for you will depend on the severity of your condition.
My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.
That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! I think you could get a nice result with implants alone. You may not have super tight cleavage, but I do think you can get a pretty result. You can always go bigger or wider in the future once you have a stable breast mound. Good luck!

Ira H. Rex III, MD · Answer

Either going under or over the muscle would give you similar results at the lower pole.  The implant has to be placed quite low to settle into the appropriate, low position.  You would need to be seen by a plastic surgeon for more counsel about fat grafting.  Everything has some risk and you need to understand how much difference it may or may not make. With regard to spacing between the breasts, it will probably remain about the same after you get implants.  Good luck with everything.

Muge Sevindik, MD · Answer

Your chest wall is wide, and the footprint of your breast on the chest is very narrow. Therefore, to enlarge and widen this footprint and bring the two breasts closer together, I recommend a hybrid augmentation. This would involve using a wide-based, round, high-projection implant along with fat harvested from your abdomen, which would be specially processed and infiltrated into the inner and upper sections of the breast. Only with a hybrid augmentation performed in this way can your desire for breasts that are close together and have upper pole fullness be achieved.

Gary M. Horndeski, MD · Answer

Your breasts are low on the chest wall and falling outward as well. Implants or fat grafting will not lift your breasts, they never do. What you need is a breast lift using the Bellesoma. This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Harry T. Haramis, MD, FACS · Answer

Both fat grafting or implants will increase upper fullness of your breasts.

However, due to your anatomy which you cannot control, the beasts will not be closer together. You will still have space between them, especially without a bra.

An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Zoran Potparic, MD · Answer

It is very likely that breast augmentation with wide base implants would help improve current shape and size. However, position of nipples will not change without transposition (moving them more medialy once implants are placed)? It is quite possible that augmentation/shaping of upper pole and medial aspect of breasts may further improve overall shape? You will need in person consultation with a very experienced, board certified plastic surgeon to discuss your options and plan surgery.  Good luck.

Mehmet Ozdemir, MD · Answer

Thank you for your question.
Based on your concerns, breast implants may help improve upper pole fullness and create a fuller, more balanced appearance. With the right implant selection and placement, it is also often possible to enhance the overall shape and bring the breasts visually closer together.
In some cases, fat grafting can be added to further refine the contour or improve cleavage, though it may not always be necessary.
A consultation would be the best way to determine the most suitable approach based on your anatomy and your desired results.

Kadir Berat Oyur, MD · Answer

Thank you for your question.
Based on your concerns, breast implants alone may help improve upper pole fullness and create a fuller appearance. In many cases, careful implant selection and positioning can also help the breasts appear closer together and more balanced.
Fat grafting can sometimes be added to further refine the contour or enhance cleavage, but it may not always be necessary.
A consultation would help determine the most suitable approach based on your anatomy and the look you would like to achieve.

Donovan Rosas, MD · Answer

It is important for patients to understand that augmentation will "augment" all aspects of your anatomy. The spacing of the footprints of the breast on the chest wall will vary from one individual to the next. Widely spaced breast will appear more widely spaced and vice versa. 
The spacing (cleavage) is defined by the pocket. The pocket is defined by the plane of augmentation.When placed submuscular, the medial/middle limit is the sternal origin of the muscle. Wide sternum  greater separation of the breasts  less dramatic cleavage. This space can be narrowed (with some risk of synmastia) when the devices are placed subglandular or "over" the muscle. There is no muscle obstructing a medial push, however, there is a higher risk of over-dissection and midline migration of the implant (the dreaded "uni-boob").
A higher profile device is narrower but will project more. A wider device can create the illusion of closer spacing between the breasts (when placed subglandular). Most patients will fit into the "moderate +" category...but this will depend upon the measurements of your breast width. That being said, it is never recommended that you stray far from your unique BWD.
Fat grafting is a much less predictable option.
And remember...love the look you choose...not the cup you desire.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Just get breast implants or would a fat graft be necessary for breasts to have more upper pole fullness and be closer? (Photos)

Answers (11)

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