What can I tell my surgeon in order to make sure my breasts won’t be far apart?
The patient in this question wanted to ensure that she had adequate cleavage after her breast augmentation. Breast augmentation surgery is a balance between soft tissue coverage and achieving a result that is acceptable for the patient. Patients need to remember that the breast gland does not naturally exist over the sternum, only the overlying fat layer does.
Implants that are placed under the muscles can only be forced towards the midline as far as the attachment of the pectoralis muscle to the edge of the sternum.
Placing the implants over the muscle allows the implants to be placed closer towards the midline however there is always a risk that there can be to much stretch placed on the medial attachment of the fibres overlying the sternum which will allow the implants to touch in the middle. Additionally, depending on the nipple position on the chest wall, placing an implant too far medially can splay the nipple out so it looks off to the side. This can be partially corrected using a wider implant, however this comes with the problem of too much lateral spill or the implant hanging over the side of the chest wall and getting in the road of the arms.
Fat grafting may provide an eventual answer to this. At the time of this writing (December 2014) this procedure is not covered as a technique for cosmetic surgery by the major medico legal insurer for plastic surgeons in Australia. The technique has been validated and proven to be safe, and is legally covered for most reconstructive surgery. However there are several questions that still remain about the technique.
Breast augmentation is all about weighing up the pros and cons of each decision that is made. Dr Gavin Sandercoe will guide you through making these decisions and the end result should be an operation that is planned in conjunction between the patient and the plastic surgeon.
The patient’s question was:
I know that breast augmentation doesn’t change your natural boobs and that it only enlarges them but my worst fear is having my new boobs be far apart. my surgery is in two weeks. What can I tell my surgeon to make sure that my boobs are full and close together? I weigh 130 pounds, i’m a 34A and I’m 5’3 if that helps at all.
Dr Sandercoe’s response was:
You need to have a discussion with your surgeon about your aims and what risks you are prepared to accept.
If you place your implants under the muscle, then the closest the implants (and therefore your breasts) will be is determined by your natural sternal width.
Placing your implants over the muscle allows you to narrow your cleavage, but comes with different risks than going under the