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Cynthia Mizgala MD FACS
Board Certified Plastic Surgeon
Member - American Society of Plastic Surgeons
Member - American Society of Aesthetic Plastic Surgery
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Questions and Answers

Wide gap when lying down after breast augmentation. What can be done?

This post originally appeared on Realself.com.

I had a BA 4 months ago (silicone,round,smooth,under,500cc mod profile (5'10,135lbs)). I love the way they look when I stand up, I have maybe a one finger space. But when I lay down they fall to the side and I have an almost 4 finger gap. I already spoke to my doctor and he says its normal, it's just the gel shifting and nothing can be done. But it feels like the whole implant is moving to the sides because the gap is not there when I stand up. I'm seeing another doctor soon but want more opinions.

Gap between breasts after breast augmentation
Many women are sensitive about a possible gap between their breasts after breast augmentation surgery. On the other hand, it is normal and natural that the gap should widen when you lay down just as it does with natural breast tissue, thus giving your breasts a more natural appearance. Smooth round implants do move more, as well. It sounds that the gap that is created when you lay down is too wide for your taste. In order to try to close the gap nonsurgically, I would purchase a bra with extra lateral support that pushes your breasts to make more cleavage and wear it 24 hours per day for 6-8 weeks. I would encourage you to massage the implants inwards (and not outwards) twice daily. This may allow for some shrinking of the outer pocket as you nonsurgically place the implants more medially.

Other options would involve a second surgery and could include:

  • suturing the pocket closed on the outside
  • inserting a reinforcement matrix, which I would decribe as a biologic patch, (acellular dermal matrix)
  • Fat grafting ,or transfering fat from another area of your body that could be suctioned then inserted into your cleavage area
The good news is that even if you decide to have secondary surgery, the implants can usually be left in or removed and put back in and the second surgery would just fine-tune your result. I would recommend waiting 6 months to 1 year before revision surgery to make sure that the healing process is complete and that there's nothing else that you choose to change. In the mean time, get a few opinions from the excellent Plastic Surgeons in Montreal, my own home town!

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