Breast Implants with my Pectus Carinatum deformity. Will I get a nice cleavage? Is it true the implants will drift to the sides?

Kuddos to your surgeon for telling you the truth! Breast implants have a tendency to drift down and out despite most chest malformations. Women need to understand that breast implants are heavy and will drift towards gravity's pull. This means down and out (down when standing and out when lying down). This will happen regardless of technique used - gravity always wins. Now, the pull of gravity is less if the implant is small=less weight. So, if you are dead set in increasing volume to your breasts do so with the smallest implant possible. Implants cause a variety of risks and complications needing maintenance at some point. Examples are: skin stretch deformities, irreversible muscle and surrounding tissue damage, nipple numbness, chronic pain, capsular contractures, infection, etc. For more information on the risks and complications associated with breast implants you can visit the breast implant revision forum on this site. Do your research. This is a good start!Best wishes and kind regards,

You should know that it is mostly the bra that gives you cleavage, not the breasts. The breast size and volume helps of course. With you pectus carinatum deformity your chest wall shape will likely contribute to the position of your implants. Since this is an outward protruding deformity, the implants will likely be displaced laterally when you lie down. This is simply due to gravity and your shape. It is very likely that your breasts already do that now when you lie down. Overall, this is not a contraindication to breast augmentation.

Breast implants only make your breasts fuller with the same shape. The really good news is, with the increased volume, it will be easier to create cleavage in clothes.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Many women that undergo breast augmentation surgery can not achieve the cleavage they desire. This is dependent on their anatomy and having a chest wall deformity could certainly be a contributing factor to not achieving as much medialization of the implants as desired. But this should not necessarily be confused with the 'implants drifting to the sides'.

Don't despair. Your Plastic Surgeon is just being honest about your normal anatomy, and how it may affect the final outcome of your surgery. Many breast augmentation patients do not have 'cleavage' at all times without some support. In addition, some movement of the implants to the side of the chest is actually desirable, as this simulates the movement of natural breast tissue when a woman is reclining. This is called 'lateral drift.' As long as the implant pocket is not made overly large, this should not be excessive. A little is good...a lot is not.Areola reduction is commonly performed with breast augmentation if necessary.If you continue to have concerns, please obtain additional consultations. I recommend that you obtain as much information/education as necessary before proceeding with surgery. Good luck Buckeye:)Dr. B

Thank you for the question. Careful breast implant pocket dissection and careful selection of breast implant size/profile will be necessary to address your concerns about the space between the breasts. Of course, there may be some anatomic limitations as to how closely the breast implants can be placed, without risking breast implant malposition complications. Remember (when it comes to breast implant pocket dissection and achievement of ideal breast implant cleavage) that each nipple/areola complex must be centered on each breast mound.
Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.  
2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers, viewing the patient's breasts in the upright and supine position, are very helpful during the breast implant selection process.
I hope this, and the attached link, helps.

Hello and thank you for your question. The truth is breast implants will make you a larger version of yourself. So yes you will still have the pectus carinatum, which may be visual to you even after surgery, but this does not mean that you will not have cleavage. Having larger breast that are soft and mobile will allow you to wear different styles of tops and bras that can still allow you to have cleavage when desired. Many women with pectus carinatum have great results with their breast augmentation despite having this irregularity. If you have any further concerns or doubts I would speak with your plastic surgeon or someone at that office who could possibly provide you with either pre and post op photos that are similar to your case, or if they have access to 3D Vectra imaging it might be helpful in simulating on you what a breast augmentation would look like. Good luck to you!

Your situation of a bony chest will always be considered by your surgeon as part of the problem, and the solution! In your case, implants will cover bony projections some do have. As the shape and slant of the rib cage normally allows the nipple areola to project slightly laterally ( outwardly), your surgeon will then place your implants toward the sternum and more importantly limit dissection laterally so the implants are placed to prevent the natural tendency to more outwardly. Nipple areola reduction can be done at the same operation if desired

With an outwardly angling chest wall, placing implants is like putting them on the peak of a steep roof at night, going to bed, and waking up in the morning to find that they have rolled down into the gutters. The chest wall anatomy sets you up for lateral drift and a wide gapping cleavage area. This can be addressed:  the surgeon needs to recognize this issue and accommodate for it by minimizing the lateral pocket dissection, choosing as wide an implant as your chest can handle, and holding the implants up front and center for 3 months 24/7 in a properly fit underwire bra so the pocket can heal them as high up near the midline as possible.