Cleavage

[mimafiga]

Hello Dr. Revis:
I'm getting a breast augmentation revision to increase size and improve cleavage and symmetry. My PS said that he will do a medial dissection( I know how everybody feels about this and symmastia). He is a very reputable PS and told me that he has never had a complication doing this. I know there is still a risk. I really want to improve my cleavage. I do have a wide sternum ( space between my breasts is at least 4 fingers), my BWD is 15 cm, My ribcage 30.My current implant is moderate 200 filled to 220L/210R ( 11 cm diameter). He wants to use now a 350 moderate + implant ( 12 cm diameter). For what I've read, I think it would be better to use 350 mod ( 13.3 cm diameter), since it has a wider diameter and will help more in terms of cleavage. What do you think? Also, how much closer should I get too my BWD to improve cleavage.. Do you think I should use an implant even closer in diameter to my BWD ( eg. 14 cm diameter). I don't want to be more than a small-med c ( I'm 5'3 1/2, and 100 lbs, very thin)....If I choose a wider diameter to fill space, will I be too big ? I know its hard to say without looking at me, but with your experience with patients similar to me...what would you suggest ( implant model, size and diameter) to improve cleavage and being a small-med c?........

Long question, sorry!! Thank you for your help!!

[Ivy]

Originally Posted by mimafiga

Hello Dr. Revis:
I'm getting a breast augmentation revision to increase size and improve cleavage and symmetry. My PS said that he will do a medial dissection( I know how everybody feels about this and symmastia). He is a very reputable PS and told me that he has never had a complication doing this. I know there is still a risk. I really want to improve my cleavage. I do have a wide sternum ( space between my breasts is at least 4 fingers), my BWD is 15 cm, My ribcage 30.My current implant is moderate 200 filled to 220L/210R ( 11 cm diameter). He wants to use now a 350 moderate + implant ( 12 cm diameter). For what I've read, I think it would be better to use 350 mod ( 13.3 cm diameter), since it has a wider diameter and will help more in terms of cleavage. What do you think? Also, how much closer should I get too my BWD to improve cleavage.. Do you think I should use an implant even closer in diameter to my BWD ( eg. 14 cm diameter). I don't want to be more than a small-med c ( I'm 5'3 1/2, and 100 lbs, very thin)....If I choose a wider diameter to fill space, will I be too big ? I know its hard to say without looking at me, but with your experience with patients similar to me...what would you suggest ( implant model, size and diameter) to improve cleavage and being a small-med c?........

Long question, sorry!! Thank you for your help!!

I'm not Doctor Revis, but I will give you my take on it...

First off, are you sure you are a 15 BWD? That is a very wide BWD, that's like country crock butter tub lids (very large, I doubt this is correct). I also have a wide sternum and I am a pretty small person at 5'1, 98 lbs. Sometimes it's all just your anatomy, I will never have close cleavage due to my anatomy (I have at least 3 fingers width). I wouldn't push off the warnings about dissecting the medial portion of your muscle. This is a very difficult thing to repair. Repairs for this from the top doctors that actually preform this procedure start at about ten thousand dollars and on;y go up from there! That's not with any guarantee that it will work. Please do think long and hard about this before you proceed. Symmastia is when your muscle is cut away from your sternum, there's no chance ever that this will ever be repaired to the way it once was, your muscle will never naturally reattach itself to your sternum.

[drdonrevis]

Good morning,

I also agree that your BWD seems to be pretty wide. Perhaps you should be re-measured by your PS and discuss the implant options with him or her. Your thinking is correct, however, that to improve cleavage you should increase your diameter to as close to your BWD as possible without going to large in volume. This is sometimes a conflict and your personal priorities must make the choice between wide enough + too much volume vs. narrower than ideal but with a volume you can live with.

I also agree regarding the synmastia. Most of the time a little dissection medially is fine if done in experienced hands, but I repair synmastia very frequently and it is a time-consuming operation, it is expensive, and it never is equal to your natural muscle's attachment along the sternum.

Best Wishes,
Don Revis, MD
www.BreastAugmentationRevision.com

[mimafiga]

Thank you both for the advice