Why are my implants so far apart? It's been about 3 months, 304cc Gummy bear moderate+ under muscle. It's about 5cm gap (Photos)

Question

I went to my surgeon, and he said I will need to go larger about 6 months post-op to fix the gap, and this is just my frame. When I lay down the gap is even larger! He's recommending approx 420-450 cc moderate plus under the muscle. I wish I had known about this gap issue prior, because I would have reconsidered the surgery or the implant at the time. Anyways, looking for any advice. PS- I'm 5'3", 105 lbs, and low body fat. I'm so upset :(

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question. In my practice, after performing a BA I recommend to my patients to limit the movement of the arms for two weeks. After that, you can move your arms taking care and always with common sense. In this regard, it's not advisable to carry heavy weights to prevent the implant out of position, and allow the formation of the physiological capsule around the implant, also to avoid pain and breast swelling. Kind regards

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry that your current breast results have not been what you anticipated.  It is difficult without an in-person examination or a full series of before photographs to see what anatomic limitations you may have to narrow your breast gap - is it a muscular issue, is your breast bone naturally wide - so I would seek a second opinion as to the possible options at improvement.

Gary Lawton, MD, FACS · Answer

The gap is most likely the result of inadequate release of the pectorals muscle medially.  If the surgery was performed through an incision on the front of the breast fold, it is a technical limitation of the approach and the surgeon.

Scott W. Vann, MD, FACS · Answer

Unfortunately your implants are far apart because your breasts are naturally far apart.  If you look at a lot of pre and post op implant photos you will see that some women have breasts that are naturally close, some average, or some like you are far apart. Your surgeon may be able to help some by waiting a few months for your tissues to stretch and adding a wider implant, but he cannot make you breasts closer. Your implants are presently directly correctly centered under your nipples. The good news is you have a very attractive, thin, athletic figure. Your breasts look great but you are not built for cleavage. Enjoy your great look. Good luck.

David Bogue, MD · Answer

When implants are placed under the muscle, there is a limit to how close the implants can appear. Your sternum may also be naturally wider. That being said, it does appear that your implants could be closer. In addition, gummy bear implants do not move as naturally as smooth implants. This is by design - the capsule adheres to the implants to restrict motion and prevent rotation. It's important to know that when choosing implants. Also, revision augmentation with gummy bear implants (anatomically shaped implants) can be tricky. The pocket must be precise to prevent the implants from rotating, requires removal of the previous capsule, and often needs drains. Switching to round implants can solve a lot of these issues - softer implants, more mobility, no need to revise the capsule, and a quicker operation.

Darryl J. Blinski, MD · Answer

Appears as 2 issues: #1 Your own anatomy of wide set breasts. #2 To lateral a dissection off pockets and to small implants.

Daniel Greenwald, MD (in memoriam) · Answer

The pockets have been inadequately dissected.  The medial pocket on each side needs to be expanded.  This is not an issue of implant size, but an issue of pocket dissection.

Why are my implants so far apart? It's been about 3 months, 304cc Gummy bear moderate+ under muscle. It's about 5cm gap (Photos)

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