Could I achieve really good cleavage with sub muscular implants? (photo)

It looks like you would probably need a lift along with augmentation. This would prevent a “rocks in socks” look. The lift would reshape your breasts to give them a less flattened out look and enhance fullness in the upper portion. The implants would then give you more volume. While the procedure may help improve your cleavage to a certain extent, your breasts are naturally set far apart so they’ll most likely remain this way after your surgery as well. 

Thanks for your inquiry and pictures.  I believe with a highly experienced plastic surgeon performing both a lift and augmentation--you can get good cleavage.  Please seek an in person consultation and good luck.  

The presence of wide set breasts is not a contraindication to surgery. Patients, however, must understand the limits of the surgery. Implants will not create cleavage in the sense that they cannot medialize wide or lateral set breasts. The implants will be centered on your native breast mound which may seemingly worsen the wide set nature of the breasts without actually changing the measurements. It is often helpful to think of breast augmentation as a magnifying glass or IMAX screen where all aspects of the breast are enlarged (+) and (-).
One option for creating a more central or medial mound is subglandular augmentation. In this scenario, the medial boundary as defined by the pectoralis muscle attachments to the sternum are not present. This can allow for greater medial dissection and by association greater cleavage (not recommended). However, this does in crease the risk of symmastia. There is also the risk of deformity which stems from failure to center the implant on the native breast mound.
Based on your photos, you have wide set breasts. Subglandular augmentation can (potentially) allow for more central implant placement. However, it is important to remember, anatomy trumps all. Thus there is a limit to how centrally implants can be placed without disturbing the alignment of implant and native breast.In my practice, I would recommend submuscular augmentation and a mastopexy (as you exhibit Grade 2/3 ptosis).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Cleavage cannot be built. Breast implants will give you more volume, a fact which will make it easier to create cleavage in clothes. From the pictures you posted, it appears a breast lift is needed as well.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

You will need breast lift and subglandular breast implants to achieve your goal.  Submuscular implants are not right for you for many reasons, including reason of not having a good cleavage. 

Cleavage is dertermined by a number of factors. Individual anatomy. Some women’s breasts are closer to the midline, other women’s breasts are further from the midline. Some patients breast muscle (pectoralis major) originate closer to the midline and others further from the midline. In many cases some plastic surgeons believe that they can obtain more cleavage going on top of the muscle. By going under the muscle, the muscle pushes the implant out to the side thus reducing cleavage. When going on top of the muscle one does not have a large object pushing the implants off to the side. If the muscle starts further from the midline, going under the muscle will result in less cleavage. By going on top of the muscle one may be able to position the implant closer to the midline. It’s important to take into account the patients anatomy and breast placement on the chest. It’s  also important to determine if the patient is a candidate for going on top of the muscle. In my practice I place implants on top and below the muscle. Btw I and other surgeons have obtained very nice cleavage by going under the muscle as well. I hope you find this information useful. Please watch the enclosed video. 

Thank you for your question. Based on your photographs you have grade 3 mammary ptosis which means that the nipple is below the level of the fold underneath your breasts. You may well need a breast lift in addition to implants to avoid the Snoopy Deformity.When a lift is done it is much safer to place the implant underneath the chest muscle. Depending on where your chest muscle inserts on your breast bone could cleavages typically possible even with implants under the muscle.