Don’t want large gap between boobs-any ways to minimize it? (photos)

Good afternoon,. Thank you for your question and photos. There are a few ways you can enhance cleavage through a breast augmentation. You can by adding on fat grafting to the cleavage area, selecting an implant with a wider diameter so they are a little bit closer together, and you can also pick an implant with a fuller projection (which will deepen the cleavage). It is important that you discuss this with a board certified plastic surgeon. Best of luck!

Hello and thank you for your question! Breast augmentation does not change the breasts you have, but rather enhances them. Think of an implant as expanding the size of your breast around your nipple. If you have wide-set nipples, the implants will increase volume around your nipples, but may not be close enough to create cleavage. I would recommend seeing a Board Certified Plastic Surgeon for a physical examination in order to determine if implants would create cleavage or exaggerate an existing gap. Best of luck! 

Implants, of any size, will not create cleavage in the sense that they cannot medialize wide or lateral set breasts. The implants will be centered on your native breast mound which may seemingly worsen the wide set nature of the breasts without actually changing the measurements. It is often helpful to think of breast augmentation as a magnifying glass or IMAX screen where all aspects of the breast are enlarged (+) and (-).
One option for creating a more central or medial mound is subglandular augmentation. In this scenario, the medial boundary as defined by the pectoralis muscle attachments to the sternum are not present. This can allow for greater medial dissection and by association greater cleavage (not recommended). However, this does increase the risk of symmastia. There is also the risk of deformity which stems from failure to center the implant on the native breast mound.
Ultimately, cleavage is essentially a function of the anatomic starting point. If you have wide set breasts, implants are only likely to accentuate this deficit. However, patients with closely spaced breasts will accentuate their cleavage via augmentation. Trying to force the mound centrally in too aggressive a fashion (via capsulorraphy) can lead to a mismatch between implant and native breast. They must be centered on each other in order to obtain a good result.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
 
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
Real Top 100
RealSelf Hall of Fame 

From evaluation of your photos alone, it would appear that you should be able to achieve an excellant, natural result with augmentation. The amount of cleavage that one can achieve is determined by the natural shape of the breast and how close to the middle the breast begins. Implants can be placed extremely close together when placed over the muscle. However , in my opinion, the problems that can arise from this ,particularly in thin women with little breast tissue ,preclude placement of the implants here. Augmentation enhances the breast, but does not completely change the breast that you have.

If you have a large space between your breasts, breast implants will not change it that much. You can consider a fat transfer to the cleavage area which will nicely create some better cleavage if that is your goal. Cleavage typically isn't something that implants create. Discuss this with both surgeons in more detail before your surgery.Best wishes,Dr.Bruno

Thank you for your question which is a common query of my patients. Your gap will depend on your chest anatomy and also the plane that the implant is put in. In order to reduce your gap as much as possible I would recommend a sub glandular (above the muscle) placement of your implants. A dual plane augmentation can not reduce your gap as the muscle inserts to the side of the chest bone and it is difficult to medalise your implants. Best of luck.

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The medial cleavage is somewhat dependent on your pectoralis muscle insertion point and on the selection of an appropriate implant.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Dear Exuberant1935,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Breast implants only make your existing shape fuller and does not build cleavage. You will have more volume, a fact which will make it easier to create cleavage in clothes. After I measure and discuss goals with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them. 
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author             
RealSelf Distinguished Hall of Fame Inductee

Thank you for the question and pictures.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery (assuming a well executed breast augmentation procedure). You are correct in that it will be important to achieve a sense of realistic expectations as you make your decisions whether or not to proceed with augmentation surgery.
 Some general thoughts may be helpful to you. Much of the final look and feel achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal. 
Generally speaking, the patient's specific anatomy ( for example, relatively wide space between the breasts) may limit how close the medial breast folds ( cleavage) will be after breast   augmentation surgery.   Also,  a patient's nipple/areola complex position must also be taken into account; keep in mind that the breast implants must be centered  appropriately under each nipple/areola complex. Otherwise, the nipple/areola complexes will seem off-center on each breast mound.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.  I find that I use round smooth silicone gel breast implants for the vast majority of patients who seek breast augmentation surgery.
4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc may mean different things to different people. 
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
  To summarize: select your plastic surgeon carefully. Communicate your goals carefully as well.  Chances are you will be very pleased with the outcome of breast augmentation surgery (assuming realistic expectations and a skillfully executed procedure). 
I hope this helps. Best wishes.