The appearance of cleavage after breast implants is primarily determined by the underlying anatomies, particularly the preoperative placement of each breast and chest shape. For this reason, plastic surgeons can only do so much.
If the breasts are inherently positioned far apart from each other, the implants will only increase their volume, so to a certain degree the cleavage may appear fuller. However, it requires at least a C to D cup augmentation to achieve such goal.
Nonetheless, the use of a good support bra remains the best solution for wide-spaced breasts.
Inexperienced doctors sometimes commit a mistake of releasing too much muscle in an attempt to place the implants closer to each other. But this approach has a high failure rate because the chest wall remains unchanged, and it often results in uniboob, or more accurately referred to as symmastia deformity.
To avoid symmastia and other deformities caused by implant displacement, it is important to work within the anatomical limits.
If there is a desire to achieve more cleavage, the subglandular technique might help to a certain extent. It involves placing the implants above the chest muscle, allowing the breast to “stick out” more.
The subglandular implant placement provides more fullness in the upper breast poles compared with the submuscular in which the device lies beneath the muscle.
However, some women find that excessive fullness in the upper breast poles does not look natural, so a good option is to use the submuscular technique.
While the subglandular technique provides more cleavage and allows the breasts to stick out more, it increases the risk of palpable and/or visible rippling, especially in thin or small-breasted women. Also, it is not advisable for saline implants because they are firmer to the touch and are susceptibility to folds, as they are only filled with sterile salt water.
Silicone implants, meanwhile, are filled with a highly cohesive form of silicone gel that behaves and feels like the breast tissue. For this reason, even after placing them above the muscle they could still provide natural-looking results.
Aside from cleavage, a good number of patients also want to achieve a slight lateral bulge, which contributes to a more feminine and curvier silhouette.
Furthermore, it is important that the implants lie approximately at the center of the nipple-areolar complex to achieve a more natural or teardrop shape in which most of the volume is in the lower poles of the breast, as suggested by Upland plastic surgery experts.