Is there a way to decrease the gap between my breasts and still have an implant under the muscle?

Sub pectoral implants will limit how close together the breasts can be in some one with a wide sternum.  However any augmentation will narrow it some what just more so with a placement on top of the muscle.  Mammography is slightly improved with a sub pectoral placement as the images can see the edges better the further the breast tissue is from the implant.  It sounds like there is no perfect solution but rather a situation with pluses and minuses on each side.  I am sure your doctor would be willing to the augmentation either way based on your preferences.  

I prefer to still go behind the muscle even in these types of situations- I think you could still get a very nice result with this pocket, in particular with silicone implants.great question and good luck!  Dr S

With your family history I would recommend subpectiral placement of implants. It sounds like you should have the implants there anyway if you are thin and have minimal Breast tissue and a wide inter mammary distance. A well done subpectoral aug will improve the gap. 

With proper implant width and placement, your can decrease your sternal gap slightly with an under the muscle breast augmentation. However, safety (unimpeded mammography) is more important than perfection in your elective breast augmentation surgery. So stay with an under the muscle approach and accept that there will be a large gap between the augmented breasts.

Placing the implant
under the pectoral muscle or what we call subpectoral implant may not produce
the same result as when the implant is placed on top of the muscle. However, if you are worried about having a
problem with a mammography later on with an implant on top of your muscle, then
you should certainly choose the subpectoral implant. An option is to increase the size of the
implants, however this would not guarantee that you will have satisfying
results.The presence of a cleavage will
still depend on your natural bone structure, which cannot be surgically
corrected. You should discuss your
concern further with your surgeon.

You can decrease the gap between the breasts and be under the muscle. It takes experience, the preservation of enough tissue to prevent a unibreast, and the correct width implant.

With your family history you should have your implants under the muscle and not be concerned about the gap. The presence of the implant even under the muscle should improve and decrease the distance between your breasts.Perfection is the enemy of good!