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Maximizing Cleavage in Breast Augmentation

Posted July 19, 2011 in Home

Women who consult me regarding breast augmentation are usually (and justifiably) very concerned about maximizing cleavage with the procedure.

These are the factors that determine the amount of cleavage following breast implant placement:

Figure 1:

Before / After

Before / After

Figure 2:

Before / After

Before / After

1. Your anatomy. Regardless of your breast size, you can probably look at your breasts in the mirror and see   whether they are close together (figure 1) or far apart (figure 2).   The distance between your breasts before surgery strongly influences the distance between your breasts after surgery.

2. The implant size. In general, larger implants create more cleavage than smaller implants.  More specifically, implants with a larger diameter extend closer to the midline than those with a smaller diameter.  If cleavage is a major priority, then use the largest implant  with which you feel comfortable.

3. Surgical technique. I routinely place first-time breast implants under the pectoralis major muscle for a variety of reasons (see my implant position blog).  Having done this operation over 2000 times, I have noticed that the pec major muscle has an outer leaflet (further from the midline) and an inner leaflet (closer to the midline).  I frequently divide the outer leaflet to maximize cleavage—while preserving the integrity of the inner leaflet.

Remember that cleavage is just one of several factors that determines the success of your breast augmentation procedure.  For more information, please see our other breast augmentation blogs and articles:

  1. Determining breast implant size
  2. Saline vs. silicone gel
  3. Safety of silicone gel
  4. Low, moderate, and high profile implants
  5. Smooth vs. textured implants
  6. Implant placement above vs. below muscle
  7. Capsular contracture

For articles that I have written on specific breast enlargement topics, please see:

  1. Cost of breast augmentation
  2. Breast augmentation with vs. without breast lift

For more information about breast augmentation–including more photos, please visit

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

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