I'm wanting to ascertain what various surgeons consider is possible with my wide chest and very limited breast tissue. (Photo)

Main wish is to reduce the gap between implants. Breast tissue is 12cm diameter. The crisalix sim & chest image with 2 circles drawn on, both simulate implants of 13cm diameter, 320 & 380cc. 1. What are best options to reduce gap at sternum . 2. Approx what can the sternum gap be reduced to & is that dependant on where my pectoral muscles stop. 3. Why does crisalix show the implants as much wider than the 2 circles I've drawn. Stats: 178cm, 154 lbs, 35 inch Width of chest at nipple line: 34cm

Doctor Answers 3

Cleavage in breast augmentation

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The presence or absence of cleavage is dictated by where your breast base is positioned on your chest. If you have got a wide distance between your breast bases in the middle, then you would have a wide cleavage even after breast augmentation procedure, although this will be less than before the augmentation. This is because your implants need to be placed under the centre of your breasts. Any attempt to place the implants towards the centre of the chest could result in your nipples being offset and to the sides of your newly augmented breasts (as can be clearly seen in your photo with the circles!). Some surgeons advocate using wide implants to improve cleavage. This will obvioulsy improve cleavage, but you do need to be aware that this will also mean your implants / breasts being prominent in the sides, under your arms. Cleavage is some thing that matters most in a dress and you will always have a nice clevage in a bra that brings the augmented breasts together.

Anatomy determines implant boundaries

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Your anatomy and the breast measurements your surgeon took will determine how close your implants will be able to be in the midline. The purpose of the breast augmentation is to enhance your existing anatomy. If your surgeon were to release more of the chest muscle towards your sternum you would risk having synmastia, which can be a difficult problem to fix. Because you have so little breast tissue to start with I think you will be very happy with properly sized implants. Just remember that any differences you have now between your two breasts will  be even more noticeable once they are bigger. Best of luck!

~Dr. Sieber

David A. Sieber, MD
San Francisco General Surgeon
5.0 out of 5 stars 40 reviews

Wide sternum

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With a wide sternum, there are several constraints that limit the size of the implant. The chest muscle comes off of the side of the sternum as well as the ribs, therefore, the most inside portion of the implant can't be any closer than the side of the breastbone. If the implants placed in the sub glandular pocket, above the muscle, it can be made more narrow than the absolute width of the breastbone. In that case, be careful in that if the center of the implant gets too close to the center of the chest,it will make  the nipples look like they're pointing outward. In your situation, I had good success with using a shaped, oval based, textured, Sientra silicone gel implant which creates the illusion of a narrowing of the space between the breasts. Best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.