This is what evry one craves and desires.With many patients you have to be careful; you don't go too medila because iof that skin bridge releases then you have the dreaded uni boob and that is tough to correct so what I recommend to my patients is to do soem fat grafting say from their tummy and add it to the space between the breast and this will give great cleavage and minimize the risk of the uni boob.
You are right, you are limited by your anatomy. If you try to force them more medially, you may develop a symmastia.
"Cleavage" relates to your anatomy.
Thanks for your question and photos. You have a very pretty result. If by "cleavage" you mean that the distance between your breasts should be closer together, there are two ways to accomplish this: 1. A wider implant centered around an imaginary dividing line through your nipple, or 2. Implants that are closer together and therefore more on the inside of that imaginary line. If you choose option 1, you will also have more width toward your arm pit, which usually bothers just about 100% of women both following cosmetic breast augmentation and breast reconstruction gif they did not experience this prior to surgery. This is apparently part of your problem now.
If you choose option 2, it will appear that your nipple/areolae are further out on the side of your breasts, instead of in the middle of your breasts. Aesthetically that can still be ok, and is considered "normal", but you have to be prepared for that new nude appearance.
I would recommend that you consult back with your plastic surgeon and express your concerns. If you feel a second opinion is required, make sure you are consulting with a board certified plastic surgeon experienced not only in primary augmentation but secondary revision augmentations as well. Also, you want to make sure that you communicate with photos of what you consider to be your idea of "ideal". Your plastic surgeon will determine which implant is likely to accomplish your desired outcome.
Best of luck to you.
Redo breasts augmentation
Thanks for submitting you frontal before and after pictures, though, lateral views would have been very helpful.
Sorry for your problem.
From observing your pictures and reading you comments, you appear to have wide cleavage and your implants are displaces laterally.
I would bet that your entry incisions are in the sub mammary crease, which is too far from the cleavage area and do not allow for consistent nice cleavage. This is exactly the reason why I prefer the sub areola entry incision, which allows for the cleavage dissection to be done under direct vision and finger feel.
The corrective measures to achieve your goal are not difficult. The cleavage area has to be dissected closer to the midline and a lateral capsulorrhaphy (internal bra ) has to be performed. These maneuvers will give you beautiful cleavage and prevent the implants from flopping to the sides.
Your best option is to return to your surgeon and discuss with him your concerns. If he declines to help you, consult with other experienced board certified plastic surgeons who perform lots of redo breasts augmentation surgeries. Check their before and after pictures in the photo gallery, to make sure that they numerous, consistent and attractive.
Best of luck,
Thanks for the question.
At this time of your post op we can talk about final results.
In my practice for cases like yours I recommend a breast revision to have your desires complete.
Dr. Emmanuel Mal
You desire for more cleavage is understandable. Its what any girl would want. It is achievable with a wider base diameter implant. It is achievable without giving you baloon breasts if you select an implant that is wider than it is tall. It is called an Allergan 410. I suggest you find someone with experience with this implant and you are likely to achieve your goals.
You are very slender built and you are also right that your baseline anatomy of your chest does affect the outcome. In your case, with more of the implant lateral then near the midline to offer more cleavage. You can only do so much dissection medial, toward the midline, and it looks like the implants are actually sitting properly and well. You can dissect further possibly to try to enhance the cleavage and/or plicate ( a surgical technique) in this area, but with your slender build and position of your sternum (midline breast bone) it's will be a challenge to improve and attain significantly more cleavage show
Thank you for sharing your question and photographs. As you mentioned anatomy does play a role in limiting the development of cleavage as over aggressive surgical dissection can lead to synmastia - the communication of your breast implant pockets. Your pictures demonstrate a very nice result and if your implants do not slide off your chest when laying down I would not advise seeking any kind of revision. Occasionally implants can develop malposition issues, sliding into a woman's armpit when on her back and this can be improved by closing off a portion of the implant pocket along the side of her chest. Hope this helps.
Sorry for your experience with a very well respect surgeon, Dr Roudner. But I personally know him to be one of the most caring surgeons. Your issue is you might have NOT understood that you could NEVER attain a cleavage based upon your chest/breast anatomy! The question begs were you told this pre operatively? In my 40 years experience with patients and personally knowing Dr R, I believe you did not understand that issue. Thus, you are now happy. BUT THERE is no surgery to correct the cleavage.
The degree of cleavage present after your breast augmentation is about exactly as would be expected based the width of your sternum prior surgery. The photos while standing show a very nice result. If the implants fall excessively to either side when you lay on your back, then it is possible to suture down the excess lateral implant pocket. This lateral pocket suturing will not increase the degree of cleavage in your case and based on the photos I doubt this lateral pocket suturing is necessary. Enjoy your new appearance!