I have a wide and large sternum and this is hindering me from proceeding forward with my BA decision! (Photos)

Patients whose breasts are separated from one another with a wide sternum can be challenging. In addition to implants, fat injections to the inner aspect of the breasts can be helpful in creating better and more natural cleavage.

Dear Miss32B,Thank you for your questions and sharing your photographs with us! You have correctly pointed that you have a wider sternum but this is still acceptable. In fact, you have adequate breast tissue which would mean that you can get a natural result with a size D. To achieve cleavage and the side boob would mean that you need to use an implant with a significantly wide base width. Simultaneous fat graft and implant augmentation can help you to achieve a natural appearance and feel. With the current advances in 3D imaging, we can use the system to calculate the ideal implant and also the amount of fat graft if required to achieve the desired look. This helps to take the guesswork out of planning and also enables the patient to visualise the after results. The volume and profile cannot be approximated accurately just by looking at the photographs. My advice is to seek an in-person consultation with a board-certified plastic surgeon with a 3D imaging system, such as the Crisalix system. I hope this answers your question. Have a great week ahead and all the best!Dr. Terence Goh
Plastic Surgeon, SingaporeMBBS (S'pore), MRCS (Edinburgh), MMed (S’pore)Fellow, Academy of Medicine, Singapore (Plastic Surgery)President, Singapore Association of Plastic Surgeons (SAPS)International Member, American Society of Plastic Surgeons (ASPS)

Thank you for your question.
It would be best to seek an in person assessment with a qualified plastic surgeon, but from your photos your sternum doesn’t seem to be excessively wide. You may have some degree of pectus excavatum, but it’s difficult to tell from the photos. I do agree with you that having a wide gap between your breasts is undesirable and a telltale sign of implant augmentation. It is possible to perform breast augmentation without leaving you with a large gap between your breasts.
The picture you showed of what you don’t want looks to be an early post op photo. The gap will be wide early on but can narrow if the surgeon planned to do that.
The profile of the implant will determine the breast shape but not your space between the breasts, that’s determined by surgical technique.
In terms of volume, you’d be looking at something in the 250 to 350 range, but it’s best to assess this in person. Virtual surgical simulations can help you decide on a size that you like.
Good luck!

Hello thereYour sternum is a little wider than some , but not severely so . Therefore I don't think it is likely to be a major problem .Methods to minimise the problem include using a wider implant base , going in front of the muscle [subfascial] and if it persists as a problem , fat grafting the inner aspect of the cleavage to create a wider breast .With respect to sizing , this is done by use of a sizer set and use of the Vectra 3D imaging system , which requires a a face to face consultation.But overall I don't think that your shape is likely to present a major problem and I think you can expect a good outcome .CheersTS

Hi Miss32B,

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. 
Implant profile is one of the important considerations to make. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This is associated with several problematic consequences.

The first issue is that the patient loses width and therefore cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants.

High profile implants do have a role in symmastia repair (when I need to narrow the base width) but otherwise I try to avoid them.

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, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Thank you for your question and photographs.  My advice would be to seek an in-person consultation with a board certified plastic surgeon.  During this consultation you will be given the opportunity to try on implants and view computer imaging if that is available.  Your plastic surgeon will be able to take measurements of your chest and advise you as to what implant would be best to meet your particular circumstances.  Best of luck.

Thank you for your question and your photos. While it is impossible to make a comprehensive assessment from images alone, your pictures do indicate a wide sternum that will need to be taken into consideration when you create a plan for your breast augmentation. The good news is that a wide sternum is not a contraindication for the procedure. To create a natural look with enhanced cleavage, an experienced specialist surgeon will be able to help you select the right implant, profile and placement for your specific situation. We also use the Vectra 3D imaging system to give our patients an accurate idea of what they will look like after their breast augmentation surgery. Good luck to you

Thank you for your question and photos
There are several variables to be considered when answering this question. It is always difficult to make a diagnosis based on photos alone, however, an augmentation with a smooth round silicone implant will achieve great results. When you meet with a board certified plastic surgeon, they will perform a set of measurements that will help determine what size of implants will fit your body.  I hope this is helpful.

A properly done dual plane submuscular breast augmentation said certainly increased your cleavage and reduce the apparent space between your breasts. You will likely need breast implants in the 350 cc to 450 cc range to achieve a D cup. Consult at least 2 experienced board certified plastic surgeons for an opinion which is much more valuable than Internet advice. Many patients with the degree of separation that you have due to sternal with have gotten excellent results.