Cleavage is often a desired outcome for many women considering breast augmentation. The amount of cleavage you can achieve after surgery depends on several factors related to your anatomy and the surgical plan. With proper implant selection and surgical technique, many women can attain their desired amount of cleavage.
What is cleavage?
Cleavage refers to the space between the breasts created when they are pushed together, typically by a bra. The size and shape of the cleavage depends on:
- The base width of the breasts
- The projection of the breasts off the chest
- The relative height of the breasts on the chest
Women with wide-set breasts or minimal breast projection off the chest often have little to no cleavage. Getting cleavage relies on bringing the breasts closer together and enhancing projection.
Factors that affect potential cleavage after augmentation
Several factors about your native breast anatomy can impact the amount of cleavage you may achieve with implants:
- Breast base width – A wider breast base means more space between the breasts. Cleavage will be limited if the base width is not narrowed.
- Breast height – Low or “bottoming out” breasts limit cleavage potential.
- Chest width – A broad chest makes bringing the breasts together more challenging.
- Breast projection – Minimal projection off the chest prevents cleavage.
- Tissue quality – Firmer, denser breasts hold implants better to enhance cleavage.
How implants can create cleavage
During breast augmentation, implants can enhance cleavage by:
- Narrowing the breast base width
- Increasing projection off the chest
- Providing upper pole fullness
- Pushing breast tissue upwards
The surgeon evaluates your existing breast characteristics and anatomy to determine the optimal implant dimensions and placement to help accomplish these goals.
Implant shape
Round or shaped implants can both create ample cleavage:
- Round implants – Provide fullness centrally on the upper pole of the breast. This enhances projection for cleavage.
- Shaped implants – Narrower at the breast base with fullness higher on the chest. Helps bring breasts closer.
Implant size
Larger implants will increase breast projection and push tissue upwards to reduce the breast base for improved cleavage potential.
Implant profile
A higher profile implant projects further off the chest wall, which enhances cleavage. Moderate or moderate-plus profiles often optimize cleavage for many women.
Implant placement
Placing the implant under the muscle generally pushes tissue upwards better for added cleavage. However, for some women, above the muscle placement gives optimal cleavage results.
Surgical techniques to optimize cleavage
Certain surgical techniques can further help attain the maximum cleavage from your breast implants:
- Pocket dissection – Precise sculpting of the implant pocket size, position, and shape.
- Lower breast fold release – Releasing rigid fibrous attachments to allow the implant to elevate tissues.
- Capsulorrhaphy – Sutures to shape the implant pocket and control the implant position.
- Concurrent breast lift – Elevating and reshaping drooping tissues.
- Fat grafting – Potentially used for pocket refinement and optimizing upper pole contour.
Breast characteristics that make cleavage difficult to achieve
Certain breast characteristics can make cleavage challenging, even with the optimal surgical plan:
- Tubular breasts – Tubular breast shape is caused by substantial tissue constriction at the breast base. This wide space between the breasts makes cleavage difficult.
- Wide chest – A broad chest walls prevents bringing the breasts together.
- Breast ptosis – Severe breast sagging requires a more complex lift which may limit cleavage potential.
- Pseudoptosis – Low hanging but non-sagging breasts are positioned too far below the clavicles for optimal cleavage.
In these cases, a staged procedure starting with a breast lift may be required prior to augmentation to allow for the greatest cleavage outcomes later.
What level of cleavage can I expect?
The amount of cleavage attainable relies heavily on your pre-existing anatomy. However, most women can achieve one of these general cleavage levels with well-planned augmentation:
- No cleavage – Breasts remain wide-set and separated.
- Mild cleavage – Breasts curve gently together.
- Moderate cleavage – More noticeable inward slope of the breasts.
- Ample cleavage – Pronounced inward breast curve with visible midline gap.
- Extreme cleavage – Very little space remains between pushed-together breasts.
Be very specific with your surgeon about your cleavage goals. Reference photos can be very helpful to get a clear idea of desired results.
How to optimize my chances of getting cleavage?
Follow these steps for the greatest likelihood of attaining your desired cleavage results:
- Choose an experienced, board-certified plastic surgeon who routinely performs breast augmentation.
- Explain your anatomy concerns and be clear about your cleavage goals.
- If you have major breast sagging or wide spacing, a lift may be recommended first.
- Discuss implant sizing and profiles – bigger and more projecting implants enhance cleavage potential.
- Consider shaped implants to reduce breast base width and increase upper pole fullness.
- Under the muscle placement optimizes cleavage for many women.
- Share any example photos of your ideal cleavage results.
- Follow all of your surgeon’s pre- and post-operative instructions.
What are the risks of prioritizing cleavage in breast augmentation?
Pursuing maximal cleavage enhancement involves certain trade-offs, including:
- Larger implants – This can increase visible rippling, palpability, and complications like capsular contracture.
- Extreme upper pole fullness – Unnatural rounded “bubble chest” appearance.
- Close implant placement – Potential interference with mammography.
- Upper implant edge visibility – More noticeable implant edges on the tops of the breasts.
- Symmastia – Merging together of the breasts from overly-tight implant placement.
Be sure to discuss these types of trade-offs thoroughly with your plastic surgeon when formulating a surgical plan optimized for cleavage.
What if I don’t get the cleavage I want after surgery?
If your breast augmentation does not provide your desired amount of cleavage, consult with your original plastic surgeon about your options, for example:
- Implant exchange to a bigger or differently shaped style
- Adding a concurrent breast lift
- Fat grafting for enhanced upper pole fullness
- Capsulorrhaphy or pocket adjustment
- Additional time allowing implants to settle and “drop-and-fluff”
Secondary revision procedures can often help attain improved cleavage results. Be sure to address any concerns early before scar tissue fully forms around the implants.
Conclusion
Many women wish to increase cleavage through breast augmentation. With careful surgical planning and proper implant selection, significant cleavage improvements are possible for most patients. Discuss all aspects of your desired cleavage results thoroughly with an experienced plastic surgeon. Follow pre- and post-operative instructions for optimal outcomes. Be prepared that certain breast characteristics make added cleavage more challenging to achieve. Additional procedures may be necessary to reach your goals. Maintain realistic expectations for safe, beautiful cleavage enhancement.
