Very wide set breasts & large sternum - I'm scared I will not be happy with my results (Photos)

Based on your own and wish photos, you seem to like larger breasts. It will not be difficult to improve your cleavage in that case and, very likely, it will not create much of nipple lateralization- spreading outwartds. However, that size of implants, as presented on your wish photos, may be too large for your chest? In person consultation with a board certified plastic surgreon with good reputation in breast surgery, is recommended. Good luck.

Hello You need make a small breast because your breasts are very big and big implants makes big problems also high risks. You need again to do breast lifting with inplants

You are correct to be concerned about your breast shape after breast augmentation. Cleavage is determined by your breasts pre-existing footprint or attachment position on your chest. Trying to change your breast footprint to increase cleavage is like trying to move the foundation of your house. It isn't very adjustable. Even if you use textured anatomic implants on top of the muscle, you will have a wide gap between your breasts similar to the photo of the patient who's results you do not like.

Thank you for your question. The shape and slope of a rib cage has a significant impact on where natural breasts sit and point. The base of the breast sits on the platform of the ribcage and the breasts naturally point perpendicular to that platform. There is a huge variability in rib cage shape and this can be challenging for surgeons to provide the optimal shape and position.
Some patients have an indented sternum (Pectus Excavatum) which makes the breasts naturally sit too close together and point straight forward. In these patients we need to try to keep the implants separated so the breasts are not permanently touching across the midline when not in a bra.
You seem to have the opposite issue with wider set breasts and more of a gap between them as well as a more lateral projection of each breast. There are some strategies that can help provide better cleavage in similar patients, such as fat grafting the medial poles, releasing some medial pectoralis major muscle to drive expansion that way and choosing wider implants. All of these manouvers have some additional consequences or risks such as more cost (fat grafting), muscle retraction and animation (with more aggressive medial muscle release) and bread-loaf deformity (due to excessive medial release of tissues over the sternum with implants above the muscle). In addition, ideally the implant is centered behind the nipple horizontally and a natural lateral nipple position adds to the difficulty of the situation.
In the end it is best to see a well respected board certified Plastic Surgeon for an opinion about your options. My comments above are meant in a general sense as a description of some of the difficulties we face as surgeons, and without a proper in-person review and exam, no specific advice can be given.
I think the main consideration for all patients is that you are paying for a procedure and not an outcome. Outcomes are highly variable and wish list results are often perfect results in perfect candidates. Better surgeons provide better outcomes but no one can guarantee a specific result. I sometimes tell my patients that no combination of personal trainer and plastic surgeon is going to make me look like Brad Pitt in Fight Club. In the end, breast augmentation is designed to make your own natural breasts larger and not specifically to make them an idealized shape. Despite this limitation, the majority of patients are satisfied with the improvement in volume and the general results related to shape and position of the breasts.

Regardless of your wide and lean sternum, those wish pics are of women with very large implants, larger than you can safely obtain in a single operation. Those women had more breast tissue and skin before their surgery than you do now, and appear to be far out from their operation(s). Aside from the gap in the woman who you don't like, she has firm and hard looking breasts because it's mostly implant (and she is either in the early stages of healing or has a firmer than normal scar capsule.) You could pursue a more complicated and expensive course by fat grafting and implant augmentation simultaneously or in stages, but you would likely need to upsize at least once to get into the neighborhood of these wish pics.

Thank you for the photos as they are very helpful. You are very correct that you have widely spaced breast with slight pectus. To maximize cleavage (the space between the two breasts) there are 3 things that need to happen: 1) your surgeon and the dissection that is performed during the surgery, 2) proper implant choice 3) favorable anatomy. The one thing that we cant control here is your anatomy. The wish photos can happen but only when you are wearing a bra. The last photo that you have posted with the nipple areola covered is more close to what you can expect.

What you have to think about is that will you be happier with your body if you have that result versus what you have now? Only you can answer that question. If you decide to move forward make certain you see a board certified plastic surgeon who has a great deal of experience in breast surgery.

Hope that helps.

Dear leannamae023,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. I wouldn't be afraid. Although it's difficult to tell from your pictures, you do have some mild chest wall asymmetry which may be associated with a mild scoliosis. All of this can be taken into consideration when analyzing the best option for you. I believe you can get a nice result with breast augmentation and recommend you see a board certified plastic surgeon experienced in breast enhancement You situation is not unique so do not be afraid. Best of luck!

Your photos do demonstrate that your sternum is on the wider side. There are tricks to help the implants appear closer together, but the width of the sternum cannot be changed. The wish photos that you provided show women with very large implants, which your frame may not be able to accommodate. Speak with your surgeon about your goals and concerns. It is important that you know what to expect in terms of results from your surgery.

First, your breasts are somewhat wide apart and the bases cannot be moved to be close together. Second, please do not choose mammoth implant like some in your photos for they will sag over time. The size is best selected based on measurements of your breasts. Two hard balls on your chest will not be pretty or comfortable.