Breast implants too far apart? (Photo)

Question

I have 250cc moderate plus saline implants that are a little over a year old. I'm not happy with my cleavage and want my breasts to be closer together. Is this possible with a revision surgery/different implant or is the large gap just due to my shape? Also when I lay down my implants fall even farther into my armpits while I thought they were supposed to stay in place.

Daniel Barrett, MD · Answer

Dear hf7zj,many women seek improved cleavage. Narrowing the cleavage plane can be done very carefully by a skilled surgeon. Moving the implants too far medially can result in symmastia or unaboob which is very difficult to correct. That being said, the right amount of pocket dissection and implant selection can create excellent cleavage. In fact, several of my patients have found that several of my before and after photos have the narrow implant cleavage look that you are describing.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

In general cleavage cannot be built. The good news is that increased breast volume makes it easier to create cleavage in clothes. A surgeon dissecting beyond the natural limit of one's anatomy could possibly create a symmastia or uniboob.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and AuthorRealSelf Distinguished Hall of Fame Inductee

Curtis Wong, MD · Answer

and technically, your implants are positioned well when standing.  If they do fall far to the sides when your back, you have lateralization and revisions can help this but its not a simple recovery nor a guaranteed improvement.  If you want less space between your mounds, you will need the pocket made smaller laterally and consider the use of textured anatomic (I cannot appreciate any situation where a textured round implant is good).  Realize that any shift of your mound more medial will rotate your nipple laterally unless you get a much wider implant that will expand in both directions (medial and lateral).

Douglas J. Mackenzie, MD · Answer

It does seem from your photos that your implants are spaced too far apart, but an exam would be needed to see what could be done.  Usually it's a capsullorhaphy, which involves closing the side of the pocket with internal stitches while opening up the medial (close to your sternum) pocket.  This can be done through the original incision site if it was a periareolar or inframammary approach.  That said, sometimes chest anatomy makes it difficult or impossible to have ideal cleavage: a very wide sternum, or if the ribcage has a prominent sternum with slanted ribs (pectus carinatum).  Remember also that cleavage is a function of clothing.  Cleavage in a bikini top or bra is not comparable to cleavage naked.  In some women changing to a wider based implant can help, but is usually not the main problem.

Christopher Costanzo, MD (retired) · Answer

From your photos it looks like your implants are in the proper position under your breasts.  It may be that you've stretched the skin somewhat allowing the implant more room on the outer part of your breast.  Evaluating you can determine whether tightening the outer part of the breast will help move them back more to the center.

Marc J. Salzman, MD, FACS (retired) · Answer

Thank you for your question and photos. Breast implants have to be centered on the patient's nipple to look right. Sometimes, a woman with a large and wide breastbone will have to accept that the distance between the breasts may be wider than she wants it today. However, there are two things it can be done to improve your situation. The first would be to place a wider based implant. In my practice, I have had success using shaped silicone gel miplants that are wider than they are tall in this situation to fill in that space.  I also think your situation could be improved by closing the side part of your capsule to cinch the breast implants a little bit toward the middle. Hope that's helpful.

Breast implants too far apart? (Photo)

Answers (6)

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