Implants sit and look very different and are wide apart - would bigger implants fix this? (Photos)

Question

They sit very different and look different.. and I can’t really go without a bra because of that. Do you think I should fix this? And would bigger implants looks better on me given my anatomical wide gap?

Sean Hill, MD · Answer

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery – Frisco, TX:
Thank you for your question, and for sharing your photos. Based on your description and images, it does appear that you may be experiencing implant malposition, specifically what we call “lateral displacement” or “wide cleavage gap.”
Let me break down what might be happening, and what your options are for correction.
⸻

Chet Mays, MD · Answer

Thank you for your inquiry!  We, here at Mays Plastic Surgery, would like to sit down with you to discuss your concerns.  Based on the photos, you breast and implants will naturally follow the curvature of your chest.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Daniel Barrett, MD · Answer

Dear Gentle817364,

breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.
Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.
While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.
If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! I do think wider implants could help get you more cleavage. I might also suggest some fat grafting medially to enhance cleavage. You may always have a slightly wider gap than some but you could absolutely get more than this. Good luck!

Donovan Rosas, MD · Answer

It is important for patients to understand that augmentation will "augment" all aspects of your anatomy. The spacing of the footprints of the breast on the chest wall will vary from one individual to the next. Widely spaced breast will appear more widely spaced and vice versa. 
The spacing (cleavage) is defined by the pocket. The pocket is defined by the plane of augmentation.When placed submuscular, the medial/middle limit is the sternal origin of the muscle. Wide sternum  greater separation of the breasts  less dramatic cleavage. This space can be narrowed (with some risk of synmastia) when the devices are placed subglandular or "over" the muscle. There is no muscle obstructing a medial push, however, there is a higher risk of over-dissection and midline migration of the implant (the dreaded "uni-boob").
With regards to your specific question, a higher profile device is narrower but will project more. A wider device can create the illusion of closer spacing between the breasts (when placed subglandular). Most patients will fit into the "moderate +" category...but this will depend upon the measurements of your breast width. That being said, it is never recommended that you stray far from your unique BWD.
And remember...love the look you choose...not the cup you desire.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Gary M. Horndeski, MD · Answer

Your breasts are asymmetrical in volume, shape and position. You have widely separated breasts and very poor cleavage. Larger implants will make your situation even worse. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person is required to properly evaluate you and propose an appropriate treatment recommendation. That said, it appears from your photos that part of your concern relates to your own unique anatomy. Your breasts overall are pretty and fairly symmetrical. Your chest wall has some asymmetry (which is very common) and your breasts have a certain position on your chest and in relation to each other which may not be easily changed or altered.

That said, it is possible that a slightly wider implant can mask the area of concern you circled in your third photo.

Please consult with an experienced board certified plastic surgeon who specifically has experience and knowledge with regard to breast augmentation revision. Best of luck to you.

That said, it is possible that a slightly wider implant can mask the area of concern you circled in your third photo.

Please consult with an experienced board certified plastic surgeon who specifically has experience and knowledge with regard to breast augmentation revision. Best of luck to you.

Tuan A Truong, MD, FACS · Answer

Thank you for your question. The appearance of the breasts after augmentation may vary, depending on the initial anatomy, as well as the implant size and profile selected. A thorough discussion and examination with your surgeon about these issues may help get some answers. If the discussion is unsatisfactory, a second opinion may be warranted. Good luck on your journey!

Camille Cash, MD · Answer

The distance between your breasts is determined by your anatomy.  There are tricks that surgeons can use to make them appear a little closer together, but larger implants will not give you significantly more cleavage.  I encourage you to visit with your surgeon to discuss your concerns.

Implants sit and look very different and are wide apart - would bigger implants fix this? (Photos)

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