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Breast augmentation patients frequently ask if they will have more “cleavage” after surgery. Cleavage, in this context, is the area between a woman’s breasts that’s particularly evident when wearing a low-cut blouse, dress, or top. The cleavage space is bordered by the sternum (breast bone) in the deep aspect and by the breasts on the medial aspect. In medical terminology, when patients ask about cleavage, they are referring to the apposition of the medial (inside) aspects of the breasts to the middle of the chest—or, in other words, medial breast position in relationship to the space between the breasts. Many patients think of cleavage as a simple narrowing of the space between the breasts with the breasts juxtaposed and touching, or almost touching. The greater the contour difference between the breasts and the space between the breasts, the greater the “cleavage.” Patients will often push their breasts together at the consultation to simulate their goal of more cleavage.

In repose (without a bra), the amount of cleavage created by the breasts is dependent in part on the size of the breasts. If the breasts are large, there is a large amount of cleavage, and if the breasts are small, then there is very little—or even an absence of—cleavage. After breast augmentation, the amount of cleavage, meaning the juxtaposition of the medial breasts, will usually increase in repose. There are many individual factors that will affect the amount of cleavage after breast augmentation, however, and these factors are discussed in reference to a patient’s specific anatomy at the time of consultation. One possible exception to improvement of cleavage after breast augmentation is the patient that has significant pectus carinatum (sometimes informally referred to as a “pigeon chest”). This causes the breasts to lie more laterally and point away from the center of the chest, so cleavage in repose would be less. The patient with pectus carinatum can sometimes improve cleavage after breast augmentation by wearing a bra that pushes the breasts more to the center of the chest.

Breasts meeting in the middle of the chest (a large amount of cleavage) without a bra is not normal or desirable. This look can be a result of symmastia (sym-together, mastia-breast), which is a condition where breasts have migrated too far towards the middle of the chest. This has been referred to as the “uni-boob” by some patients, which describes the appearance of one breast across the entire chest. In this condition, there is no cleft between the breasts. There are a number of factors that can contribute to symmastia, which includes breast implants that are too large in volume, breast implants that are too wide, and breast implants that are placed in the submuscular (under the muscle) plane. Awareness of these risk factors can help avoid this condition.

The important thing to remember is that cleavage is created with a bra and is not a normal anatomical situation in the vast majority of patients. The amount of cleavage that can be created after breast augmentation will vary from patient to patient depending on the individual anatomy. As a result, breast augmentation can improve the amount of cleavage in some patients—but not necessarily everyone.

To make an appointment for a breast augmentation consultation with board-certified plastic surgeon Stephen M. Herring, MD, please feel free to call 910.486.9093 or contact us online today.