Is it possible to reduce distance between breast implants to get more cleavage?

Question

MTF trans girl looking to get BA. I have a relatively wide torso/rib cage and I am going to go w 350-400cc to get a solid D-cup. I however want good cleavage and I don’t want two balloons sitting on my chest far apart from one another. Is there a way to bring them closer together and minimize that gap in between so I can get nice cleavage when wearing a bra/bathing suit? Also would you recommend over or under the muscle? I don’t have much skin thickness there.

John LoMonaco, MD, FACS · Answer

First off, very hard to tell without seeing photos of you.  But in general, the implant must be placed and centered wherever the nipples is located like a "bullseye."  If the implants are moved too far toward the middle, or too far off to the sides, the breasts will appear very odd.

As a general rule, going under the muscle gives a nicer flow to the breasts and helps avoid them looking like round balls.  However, implant movement towards the middle can be limited when going under the muscle.

Krishna Vyas, MD, PhD, MHS · Answer

Yes, it is possible to reduce the distance between breast implants to create more cleavage, even with a wider torso or rib cage. One key factor is the choice of implant placement. For those with less natural tissue, under-the-muscle (submuscular) placement is often recommended for a more natural look, though it can sometimes increase the space between the implants. Alternatively, over-the-muscle (subglandular) placement can bring the implants closer together, creating more visible cleavage. Additionally, the implant profile (low, moderate, or high) and shape can significantly influence how the implants sit on your chest. A skilled surgeon can also utilize surgical techniques like dual-plane placement, which combines the benefits of both submuscular and subglandular placements. This helps create cleavage while providing a more natural overall shape. Furthermore, your surgeon can customize the positioning of the implants to sit closer together, giving you that desired cleavage effect. Discussing your specific goals with an experienced aesthetic breast surgeon specializing in gender-affirming surgery will help ensure you get the best results for your anatomy and desired appearance.

ABOUT DR. VYAS
Dr. Krishna Vyas, MD, PhD, MHS, is a highly trained plastic surgeon specializing in aesthetic surgery and breast surgery, including breast augmentation, reduction, lifts, and gender-affirming surgery (such as chest masculinization and feminization). With advanced training from institutions like Harvard, Mayo Clinic, and Johns Hopkins, Dr. Vyas is recognized for his expertise in breast and chest sensory nerve restoration. His PhD in clinical and translational science focused on stem cells, fat grafting, and improving outcomes in aesthetic surgery and breast surgery. Dr. Vyas has served on the editorial board for several medical journals and platforms and has over 200 research papers and talks. His research focuses on aesthetic surgery, regenerative medicine, stem cell biology, fat grafting, breast surgery, and gender-affirming surgery. Recognized for his expertise, Dr. Vyas was appointed an Instructor of Surgery at Mayo Clinic and served as an Assistant in Surgery at Harvard Medical School and Massachusetts General Hospital.

Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained 
Aesthetic Plastic Surgeon
New York, New York

Is it possible to reduce distance between breast implants to get more cleavage?

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Is it possible to reduce distance between breast implants to get more cleavage?

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