Is it possible to ask for breast implants placed close together to reduce cleavage gap? (Photo)

Thank you for your question and photos.  The gap between the breasts that you notice as being more pronounced after surgery is based on the patient's anatomy.  The cleavage cannot be changed to make the gap smaller without there being subsequent changes to the breasts (change in nipple position).All the best,Dr. ResultsMiami, FL

Breast Implants definitely improve cleavage - but to what degree is the tricky part. The question is straightforward but the answer is not. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon especially when it comes to cleavage issues. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below:

The gap between the breasts is usually related to your natural build.  The implants usually center themselves Nader the nipples.  Therefore if your nipples point toward the side, the implants would be further apart than if they point straightforward.

How close the inner edge of your breasts are to one another without a bra after augmentation with implants depends on several factors.  All women can have it, if that's what you really want, but there may be trade-offs.  Width of the implant used (from side to side), positioning of the implant on your chest, submuscular vs. subglandular placement, the current inner edge of your native breast tissue, position of nipples on your breasts (if nipples far out to the side, the more centrally placed your implants are, the more eccentric on the breast mound will be your nipple position), and the cant (direction, inclination) of your ribs all affect where your inner edge will be.  Even so, if smooth surface implants are placed beneath the muscle, you may have cleavage immediately after surgery but over time, muscular contraction against the implant can push it laterally so you lose your cleavage subsequently.  Capsular contracture (scar around the implants) can change breast shape over time to a more globular shape (more projection, less diameter), widening the space between your breasts over time.  To correct this, additional surgery is indicated.Hope the above simplified explanation is helpful.  Like so many issues and problems in plastic surgery, the answer depends on your situation.  Most often, women who request cleavage without a bra can have it, but not always, depending on what size they want to be and their other anatomic features.

As you mentioned, no one really likes a wide gap between the breasts, and there are many reasons why this might occur after breast augmentation. There are certainly things that your surgeon can do to maximize the chances that you will have a narrow, appealing cleavage, but your existing anatomy does play a role too. When implants are placed beneath the pectoralis major muscle, as is most common, the medial attachments of the muscle along the sternum or chestbone define how close to the midline the implants can be placed. The muscle can be lifted off the sternum to some extent to narrow the cleavage, but excessive lifting of the muscle can result in unsatisfactory conditions such as symmastia (uniboob). Usually, part of the lower portion of the muscle is also released to allow the implants to settle down and towards the midline, not up and out. Your surgeon should be able to give you some idea of the cleavage that is realistically and safely attainable for you. Be sure to let him or her know your wishes.

I appreciate your question.My partners tv show "botched" is about getting the right advice about plastic surgery and trying to avoid problems. Breast cleavage is attainable but is based on your anatomy. Anything overdone or brought too close together can have problems in the long run such as symmastia. I fix a lot of this so its best to avoid it from the beginning.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

In most patients a nice cleavage can be achieved. Anatomy does have contribute to the ultimate result, but the use of higher profile or even ultra high profile implants can help improve the cleavage zone. Additionally, an experienced plastic surgeon can dissect the muscles just enough to get the result without causing symmastia. I hope that helps.

Mhelmeczi,Many women seek improved cleavage. Narrowing the cleavage plane can be done very carefully by a skilled surgeon. Moving the implants too far medially can result in synmastia or unaboob which is very difficult to correct. That being said, the right amount of pocket dissection and implant selection can create excellent cleavage. In fact, several of my patients have found that several of my before and after photos have the narrow implant cleavage look that you are describing.Please don’t hesitate to reach out if you have any more questions.I hope this was helpful,Dr. Daniel BarrettPlastic SurgeryBeverly Hills, CA

Cleavage is dependent on both your anatomy and surgeon technique. Both need to be examined by your Board certified plastic surgeon 

Hello, it is possible to adjust the implant position to some extent, but problems can arise if the implants are placed too close together or if there is insufficient tissue coverage of the implants in the central part of the chest (like synmastia, rippling, etc).  The final outcome is affected by your pre-existing breast shape and position.