For women undergoing breast augmentation surgery, the location as well as the size of the breast implants is of critical importance. While women can participate in the selection of the size of their breast implants, they have little say in where they are positioned on the chest wall. Ideally the plastic surgeon centers the implant with the nipple-areolar complex positioned over or close to the center of the newly projected breast mound.
But many women’s native breast mounds are not usually symmetric and the position of the nipple-areolar complexes may be positioned fairly far to the side. Such widely spaced breasts mound and lateralized nipples pose an aesthetic compromise that is important to diagnose and discuss before surgery.
While many women want to have their breast implants create cleavage, or be as medialized as much as possible, the limits as to what can be achieved is their natural breast mound location. Widely spaced breasts simply pose limits as to how close breast implants can be placed to the sternum. A good rule of thumb is that no more than two-thirds of the implant’s base width can be placed medial to the areolar edge. By making this measurement it can be seen before surgery how close the breast implants can be placed to the sternum. (or how much of a sternal gap will persist afterwards)
It is often said that breast implants don’t make cleavage…that is what bras do. While there are certainly examples of where breast implants can be placed very close up to the sternum, this is primarily a function of the woman’s natural breast mound position as well as the size of the breast implants used. For many women undergoing breast augmentation, their desired close spacing of the breast implants is often not a reality.
Dr. Barry Eppley