The breast has many aesthetic features of which the sternal gap is one of them. The distance between the breasts is most commonly a consideration in breast augmentation surgery in an effort to create improved cleavage. But it can also be an issue in other forms of aesthetic breast surgery as well including breast lifting/reduction as well as in breast reconstruction.
Short of what an implant can do, reducing the distance between the breasts across the sternum requires soft tissue augmentation. Fat injection grafting offers an ideal method to do so. Fat grafting to the breasts has an established history although it has been typically applied in larger volumes for a breast augmentation effect.
In the November 2017 issue of the journal Plastic and Reconstructive Surgery an article was published entitled ‘Breast Cleavage Remodeling with Fat Grafting: A Safe Way to Optimize Symmetry and to Reduce Intermammary Distance’. In this clinical series the authors treated eighty-six (86) patients who underwent various types of breast reshaping surgery. Fat injections were done in the medial pole of the breasts to reduce the degree of separation across the sternum or for medial pole asymmetry. Before and after intermammary distances were measured before and after surgery.
Their results showed a significant reduction in the mean intermammary distance from an average 3cm to a 1.7cm distance at one year after surgery. Only one fat grafting complication occurred which was an oil cyst that required aspiration.
Submuscular breast implant augmentation offers an ideal time to create improved cleavage by fat injection grafting. The breast tissue above the muscle remains unaffected by the submuscular pocket and does not connect with the implant pocket. For those women with widely spaced breasts who are undergoing breast augmentation surgery, fat injections offers a reliable method to enhance their cleavage as well.
Dr. Barry Eppley
Indianapolis, Indiana