Virtually every breast augmentation patient wants to know the answer to the question, “Will I have more cleavage after my surgery?” The answer is, “Maybe!” Let’s see why.
Most breast implants are place behind the pectoralis muscle of the chest to allow for the best possible mammograms and to minimize the risk of hardening of the breasts after surgery. If the implant is behind the muscle, however, it cannot come any closer to the middle of the chest than the muscle will allow. If the pectoralis muscle started in the middle of the chest, one could position the implants quite close to the middle of the chest, giving excellent cleavage. Because it does not, you can only position the implant as close to the middle as the muscle will allow. Many patients have a wide flat area over the lower part of the center of the chest that has thin skin and minimal fat. That area cannot be improved by surgery since the pectoralis muscle starts lateral to it and the implant lies under the muscle.
Some patients have breasts that are widely separated to begin with. Surgery cannot change that. Although the implant will give the patient more fullness over the inner part of the breast, to overdo it by shifting the implant far in toward the middle of the chest will cause the nipples to rest over the outer part of the implant, causing them to point outwards – an unattractive result.
One way of trying to increase cleavage is to use a wider implant, known as a low profile implant. The wider the implant, the more fullness there will be over the inner part of the breast. Once again, though, avoid an excessively wide implant since it will then hang out over the side of the chest, producing a wide breast that most patients find unattractive. Another thing to keep in mind is that the wider the implant, the less projecting it will be. Some women like the idea of a great deal of upper breast fullness. The high profile implants tend to give more of that fullness than the low profile implants, but they will also give less cleavage.
In the final analysis, cleavage is in large part what a patient starts with. It can be affected by the choice of implants and how they are positioned. In many cases, though, the best solution to increasing one’s cleavage is to use a bra that pushes the breasts inward, producing the desired fullness.
Should you have further questions, please contact my office.
George Sanders, M.D.