How do I get more cleavage with my breast implants?

Modified on | by Dr. Ricardo L. Rodriguez

Types of cleavage

Types of cleavage with breast implants.
Types of cleavage with breast implants

A lot of patients who come in for a Breast augmentation or a Breast lift with implants consult will usually make a comment about cleavage.

Some patients don’t want “that fake look,” yet others specifically ask for “a lot of cleavage.”

It helps when patients bring in pictures, because cleavage is one of those words that, like “natural look,” can have different meanings to different people. In this post I will talk about cleavage, and how it is related to surgical technique and patient anatomy.

What does cleavage mean?

The word cleavage is derived from the word cleft. According to the Merriam Webster online dictionary , a ‘cleft’ is a V shaped indented formation.

The misunderstanding between plastic surgeon and patient comes from knowing which end of the “V” we are talking about!  Does the patient want upper pole fullness, which is prominent at the upper part of the breasts? Does the patient want medial cleavage, which is breasts that are close together at the midline? Or is it both upper pole fullness and medial cleavage?

The surgeon has two surgical methods to improve cleavage with breast implants.

1) Implant placement

Cleavage can be increased by the placement of the implant. The implant can be placed higher up on the chest wall to get upper pole fullness. The implants can also be placed closer to each other on the chest wall to create medial cleavage. Naturally large breasts usually have good medial cleavage, but because of their weight they usually descend on the chest wall, so they don’t have upper pole fullness.

2) Implant dimension

The second way is by using the implant dimensions. The general rule is, the larger the implant, the better cleavage you will get, both Medial Cleavage and Upper Pole fullness. That is because as implants get larger, their diameter increases, so they occupy more space on your chest wall, both medially on the upper pole of the breast. Implants can all be either High profile or moderate profile. High profile breast implants will typically give more upper pole fullness .

Cleavage and a smaller breast?

But what if you want Upper Pole fullness or Medial cleavage, but not a huge breast?

Implant manufacturers have responded with a variety of implant dimensions, including:

  • implants that have a large diameter and low Profile (moderate profile implants), or
  • high profile implants that have a small diameter.

Upper Pole Fullness or Medial Cleavage, or both?

These new high and low profile implants can really help a surgeon fine tune his choice of implant to get a result as close to the patient’s desire as possible. A final consideration with regards to cleavage is the patient’s breast anatomy.

The patient’s chest wall and native breast position also have some bearing on final postoperative cleavage, especially medial cleavage. Some patients have an average shaped chest wall, but breasts that are spaced wide apart. It is usually hard to get good Medial Cleavage on these patients.

Other patients have a mild or pronounced hollow on the middle of their chest (pectus excavatum), and they usually get a very good medial cleavage. The opposite chest shape where the center of the chest cage is prominent (pectus carinatum). It is hard to get good medial cleavage on these patients. Finally, if your nipple position is low, you may need a Breast lift to get the kind of upper pole fullness you want.

In summary, when going to see your plastic surgeon about a breast augmentation, and you are concerned about cleavage, you would be wise to discuss carefully the final implant choice. If possible, bring pictures of what you have in mind.

It may be impossible to get what you want given your body type, but it helps the surgeon understand your goals and manage your expectations. Secondly, rather than use ambiguous terms like cleavage, use descriptive terms such as upper pole fullness and medial cleavage that help the surgeon visualize what you want.

(originally published on January 6, 2009)

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By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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23 thoughts on “How do I get more cleavage with my breast implants?”

  • Steph says:

    I had silicone implants (under muscle) put in over a year ago, and for the most part love them. I'm wondering if l can now have fat transferred to my breasts. They're soft, but not as soft as my natural fat and l'm hoping fat on top of the muscle and implant will increase natural soft ess and increase natural bounce/movement(l was a small A and went to a small D). Is this even possible?

    • Dr. Ricardo L Rodriguez says:

      Steph: We do a lot of fat grafting to breast. In your particular case the lack of softness may also be due to a small amount of capsular contracture, as a soft silicone implant in a loose capsule feels very normal. It has been more than a year so your implants should be softer by now. In any case, I will have Kelly at kelly@cosmeticsurg.net contact you.

  • Shannon Broadus says:

    I had breast augmentation a little over a year ago. My breast started ripling so I got another surgery. My breast are starting to ripple again. What can be done now

    • Dr. Ricardo L Rodriguez says:

      Shannon: You have several options: Are your implants over or under the muscle? Are you very slender of normal weight? Are your implants saline or silicone? In any case, to give you a reasonable answer I would need to know all those details. If you are interested, contact Kelly at kelly@cosmeticsurg.net to set up a virtual consult.

  • Tasha says:

    I had breast augmentation and after I ended up with less pronounced medial cleavage. I wanted pole fullness can this be corrected? Surgeon said it is because of my chest bone and there is nothing he can do.

    • Dr. Ricardo L Rodriguez says:

      Tasha: I would need to see your post op pictures and if possible your preop pictures. In any case I'm sure we could find an implant that will give you more upper pole fullness. I'll have Kelly at kelly@cosmeticsurg.net contact you. We're looking forward to seeing you!

  • Janet says:

    Very interesting , I will definitely be doing more research in the area of cleavage when it comes to breast implants. I personally prefer having a lot of cleavage. Thanks Dr.Dr. Ricardo L Rodriguez for writing this article.

  • katie says:

    i would like to know around what the prices range are for a breast life and implants with cleavage, and a butt lift, and is there anything i can do about stretch marks?

    • Dr. Ricardo L Rodriguez says:

      Katie: Unfortunately, there is not much that can be done for stretch marks, except when they are in the lower belly, in which case you can do a Tummy Tuck and just cut out the entire skin. As far as prices go, you can contact Kelly at kelly@cosmeticsurg.net

  • Odalys says:

    Thank you so much Dr. Rodriguez, you were honest and straight to the point. Happyt New Year by the way! I attached a link of my post to give you a better idea of what I'm talking about. It's before surgery, right after, and basically today i still look like the last picture which is smaller, but still saggy and basically the same. I hope implants will help correct the problem and your left corner patient would be a great result for myself. Thanks again! http://www.realself.com/question/lift-4-months-unhappy

    • Dr. Ricardo L Rodriguez says:

      Odalys: After seeing your pictures there are a few things that come into play. There is fat redistribution. When you get a Tummy Tuck with a breast reduction and lipo, it's not like the fat will disappear. As long as your calorie intake is the same and your exercise calorie expenditure is the same, you will slowly build up your weight to what you weighed before. Sometimes you pick up fat in the lateral aspect of the breast, so even if the breast is smaller, the extra fat buildup in the lateral chest fills up the bra. I don't use that pattern for breast reduction, I use a vertical scar. It gives you more lift and projection. We'd love to help you, call Kelly@kelly@cosmeticsurg.net, she'd love to help you out.

  • Odalys says:

    Hello! First and foremost, Happy Holidays! Dr. Rodriguez, I came across your article through real self and I have a few question. I was a 36DD preop extremely saggy super full of stretchmarks (I'm 24). I had a BL/BR with no implants and of course, the day of surgery, it looked awesome but it only took a few weeks to look the exact same as before surgery only smaller. My surgeon and I agree I have poor skin laxity and the skin is generally thin. I love the picture of the breasts on the upper left corner as I would hate for my implants to look anyother way. Exactly where are the implants placed for this specific patient. I have discussed with my doctor getting 350cc behind the muscle and hope to achieve these results which I hope will last more than a few weeks. I'm 7 months post op. Any advice? Thanks! :)

    • Dr. Ricardo L Rodriguez says:

      Odalys: I hate to give you advise on this because it will put your surgeon on the spot and he has his own way of doing things. You are better off printing my picture and showing it to him and asking him what the best way is to get something like in the picture. Remember: "LIKE", you are not going to get a result exactly like in the picture because you are starting from a different point. BTW, the patient has the implants behind the muscle.

  • Lucia says:

    I had a breast augmentation two months ago, and my breasts were too close together. I do have wrinkles between my breasts from sleeping on my side, too. The Intimia pillow actually helped me, they don't look like a uni-boob anymore, and my wrinkles are much smoother after every night I wear it. I would never go to bed without Intimia, I love it! It's so comfortable, too. I could not wear a bra to bed, it's too uncomfortable. No doctor can tell me otherwise, I've tried it for myself.

  • cindy says:

    I would also recommend that you try using the INTIMIA breast pillow (better than sleeping with a bra/pad etc). It is amazingly comfortable, soft and light weight. It will keep your breasts in the perfect position during sleeping, avoiding the formation of cleavage wrinkles and pressure while asleep. It is AMAZING. check it out at intimia.com.

    • Dr. Ricardo L Rodriguez says:

      Cindy: I usually don't respond to spam, but this time I took the time because I thought it would help patients. This product is THE WORST THING YOU CAN DO if you want to improve your cleavage after a breast augmentation. As a matter of fact, it is designed to keep the breasts APART after surgery, which will give the breasts an appearance of being far apart with a huge gap in the middle. This product claims to decrease the wrinkles between the breasts by SEPARATING the breasts. Whether that works or not is to be debated, and there is ABSOLUTELY no studies proving that it does.

  • Jennifer Baiely says:

    how do you know if you need an implant with a breast lift? i know i need a breast lift because my nipples point all the way down and i may be really full as a 44 dd but they are so sagy if you dont put them in a bra you wouldnt know i was that big. i have been like this since i was 12 and got my breast. why did they grow in like that? was it because i grow really fast and large? and it got worse having 2 kids in 2 years breast feeding both of them. so i hope you can help.

    • Dr. Ricardo L Rodriguez says:

      "Narrow Pelvis" You are right that if you have a narrow pelvis, when viewed from the front you may still lack width. This implies that you will have good projection In this case, I would just inject fat into the area of the greater trochanter ("saddle bags"). I have done this in the past and it works great.

  • Louise Curry says:

    can i tape my boobs to make them closer .Had surgery and they are separated. Can you recommend a tape?

    • Dr. Ricardo L Rodriguez says:

      Louise: It all depends on how the surgery was done, how long ago it was done, and your body type. After 2 weeks or so it will be very hard to change the position of your implants. Some women have chests that are more prominent at the breast bone, and it is very hard to get cleavage in these cases. If anything, I would place pads on the side of your breasts inside the bra, to push your breasts medially. In your particular case I would need more information before making a definitive recommendation.