It’s not unusual for patients to have specific aesthetic goals for size, contour, and cleavage following breast augmentation surgery. Unfortunately these aesthetic goals aren’t always easily accomplished and for this reason compromises may occasionally be necessary. This is frequently the case when patients are concerned about cleavage following surgery.
Poor cleavage can occur for a variety of reasons. In rare cases, poor cleavage may be related to technical considerations. Examples might include too much lateral breast pocket dissection or inadequate medial pocket dissection. In other cases it might be related to the usage of implants that have inadequate base width.
In the majority of cases, inadequate cleavage is related to anatomic considerations. These include lateral sloping chest walls, the breast shape, and lateral positioning of the nipple areola complexes. It’s important to center the implant beneath the nipple areola complex. Efforts to create cleavage by moving the implant in an inward direction can result in malposition of the nipple areola. In these cases, the nipple areola would look as if it’s sitting on the side of the breast.
If you’re considering breast augmentation and cleavage is one of your primary aesthetic goals, it’s important to discuss this issue with your plastic surgeon. Your surgeon should be able to perform an examination and discuss any limitations imposed by your unique anatomy.