Do I have a large gap between my breasts? Will it look bigger with implants? (photo)

Question

I have breast augmentation booked for end of April 2024. I am now worried that I have a large gap between my breasts and that it will look even bigger with implants. My surgeon mentioned the gap. He said that my toned pectoral muscles give the illusion of a smaller gap and that it will not be possible to create cleavage with implants. Any thoughts or advice would be greatly appreciated!

Daniel Barrett, MD · Answer

Dear Onelove79,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! I'll have to politely disagree. You do not have a large gap, and I think you will have beautiful cleavage with implants. Good luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

Cleavage is made with clothes, a fact which will be made easier with larger breast from your augmentation. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Payman Danielpour, MD, FACS · Answer

Thank you for your question
I recommend that everyone that is having a breast augmentation should have a 3-D simulation in order to get an idea of what your final results will look like, and you can see different sizes on your frame.
I would look for a surgeon who can show you a simulation.

Brian Bassiri-Tehrani, MD · Answer

This is a good question. With implants, it is difficult to fill in the gap between breasts. If implants are placed too close to the middle to fill in that area, it can risk having a uniboob look (AKA symmastia). Additionally, the closer to the middle the implants are placed, the more outward (lateral) the nipples and areolas are pointed, which can look odd. 
To achieve a more rounded look, fat grafting can be a good option for an isolated procedure or with implants depending on your goals. Hope this helps!

Ira H. Rex III, MD · Answer

I think your doctor has given you and excellent explanation of how things work.  From your photograph, I would expect he would get an excellent overall result with breast augmentation.

Karl William Schwarz, MD · Answer

I think you have great spacing between your breasts and would get excellent cleavage after surgery. Something we cannot change during any breast surgery is where the breast is on chest. Some patients will have a low position of the breasts which is what we call a low footprint. These are the types of people you see at the pool with a bikini that covers their breasts and it wraps around their back and over their breasts (a strapless bikini) and it looks as if it is worn almost on the upper abdomen. Some patients will have breasts that are placed more towards their back and they will have a widely spaced cleavage. Your breasts are placed in a good position not too close and not too far away. When an implant is placed in your situation the implant will fill out the breasts and give you good cleavage with good spacing.

Now you may be referring to a depression in your chest between your breasts. This is pretty common in tall, thin patients so it can deepen the cleavage but I think what is most important is the spacing between breasts and yours is good. There is nothing we can do to the depression in the center aspect of your chest as it comes from your sternum shape. However I don't see anything in your photo that is concerning about this and your sternum appears perfectly normal.

I think you will have good cleavage and a nice shape after a breast augmentation and you look like a good candidate for the procedure.

Camille Cash, MD · Answer

The space between your breasts is not large and will not look larger with implants.  From the photo it appears you are a good candidate and should have a nice result.

Connie Hiers, MD, FACS · Answer

Your gap is not large, and you should do very well with implants. I do recommend placing the implants behind the muscle for a better look and support.

Mats Hagstrom, MD (license on probation) · Answer

You can’t really change your own anatomy.
It is important to recognize your own candidacy for the procedure.
It’s a little hard to tell for sure from the pictures but perhaps you have a mild pectus excavatum. 
Each plastic surgeon will have their own level of comfort on how close to the midline they open the pocket for breast implants.
You never want to go all the way, or the complication known as symmastia may occur
There are three variables that determine the outcome of breast augmentation surgery.
The first is the patient candidacy. This includes variables like breast, asymmetry, breast position on the chest wall, breast ptosis and breast divergence.
The second variable list of choice of implants in regards to size, shape, and type.
The third variable is the surgeons ability to place the implant in the correct anatomic position.
I generally recommend patients have multiple in person consultations before selecting a provider and scheduling surgery.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar body characteristics to your own.
It is important to understand your own candidacy for the procedure.
Variables that alter candidacy need to be understood because they will impact the outcome.
Patients can have surgical perfect outcomes and be unhappy with breast augmentation because they didn’t understand That their own candidacy was a little less than ideal for the procedure.
This happens quite frequently.
It’s common with patients who have breast divergence.
Divergence tends to be amplified with the projection of implants.
Implant selection is also very important.
Patients who select excessively large implants are going to have increased undesirable, side effects, increased, complication rates, and increased the rate of revision surgery.
An experience provider should have no difficulty showing you the before, and after pictures of at least 50 previous patients.
Being shown only a handful of pre-selected images, representing only the best results of a providers career or of patients who don’t look similar to what you do may be insufficient to get a clear understanding of what aver results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they have actually done.
 Ask each provider what their most common indication for doing revision surgery is, what their revision rate is, and what their revision policy is.
All plastics surgeons do revisions.
Claiming to have a close to zero revision rate is not at all ideal.
It means that somebody is not offering the best outcomes for their patients. 
The one complication I would be most concerned about is providers who end up having implants that bottom out on a regular basis.
This undesirable outcome is highly dependent on how the procedure is performed and tends to be complex, and sometimes difficult to treat during revision surgery.
Implants bottoming out is also related to using excessively large implants.
Best,
Mats Hagstrom, MD

Do I have a large gap between my breasts? Will it look bigger with implants? (photo)

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