It was my first time having a BA consultation, and I did not explore profile very much. I have slightly lateral nipples, and my breasts are somewhat perky at 34A after having two kids and doing two years of breastfeeding. I want to be a full C-cup/small D-cup, but I know the implant has to be centered behind the nipple and I’m worried I’ll have a large gap. Which profile is best to close the gap, and can I go up in cubic centimeters to make up for the fullness possibly lost with a wider implant?
So, I think this is a great question but impossible to answer. :) Your base diameter will determine profile when you select volume. You're right that if you go too high of a profile you'll have a wider gap, but that's true for anyone no matter where the nipples are. I would encourage you to choose volume based on either anatomic sizers you can try on and/or standardized imaging like Vectra. Once you have that, I would speak with your surgeon regarding the profile. You are correct that the lower the profile for any volume you'll have a wider implant. Good luck!
Published on Jul 11, 2012
No implant is going to close this gap. You could have a modified uplift/crescent lift that I do which should help.
Published on Jul 11, 2012
Thanks for your question. Your situation is a common one, and since we have a wide variety of implant types and profiles to choose from, I'm sure that there will be one that works best to achieve your goals. You're right in recognizing that we would not want to place the implant too close to the middle of your chest, because that would further displace your nipples laterally. In general, using a moderate profile implant works well in this situation, so that you can have some medial fullness for cleavage, but also have the implant placed laterally enough that your nipples are well-positioned over the implant. Vectra 3D imaging has been really useful in our practice for simulating what the results would look like on your body with different implant volumes and profiles. All the best!
Published on Jul 11, 2012
The spacing of the breast (cleavage) is defined by the pocket. The pocket is defined by the plane of augmentation. When placed submuscular, the medial/middle limit is the sternal origin of the muscle. Wide sternum = greater separation of the breasts = less dramatic cleavage. This space can be narrowed (with some risk of symmastia) when the devices are placed subglandular or "over" the muscle. There is no muscle obstructing a medial push, however, there is a higher risk of over-dissection and mid-line migration of the implant (the dreaded "uni-boob").
Alternatively fat grafting can be used to build up tissue volume in the central aspect over the muscle creating the illusion of cleavage. However, as with any fat grafting procedure, the results can be unpredictable based on graft take vs. resorption.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Published on Jul 11, 2012