Some women get more cleavage naturally because of chest wall type

Why do some women get more breast cleavage with Breast augmentation than others? There are many reasons, but one of them is a function of your chest wall type.

Some patients have a chest wall shape that is not really straight. Those patients either have a concave, hollow chest, in which the chest slopes towards the middle, or they may have an outward curved chest wall, or bird like chest, in which the middle part of the chest is the highest part like the women in the video still shown below.

These conditions are medically referred to as:

  • Pectus excavatum – the concave breast, which is sunken in the middle
  • Pectus carinatum – the bird like , or outward curved chest wall

Some of my patients have a mild degree of one of these chest forms. They may not even realize it. To determine if your chest wall has a mild form of either of the two, stand to the side in front of a mirror. It is easy to see the pectus carinatum (outward curved), as you will see that your middle sternum bone is higher in the center. For the concave breast, the pectus excavatum, you would see the opposite, a sunken area along the middle axis.

If you have pectus excavatum type of chest wall then you are lucky in regards to Breast augmentation!  This type of breast wall will naturally give you a more defined cleavage with breast implants because the implants will migrate towards the center. Cleavage on these women will be more defined. Additionally, these women usually have the option of going with high profile or moderate profile implants.

Women with the pectus carinatum , however, do not enjoy the same freedom of implant selection. If you have a chest which is curved outward, the implants will have a tendency to shift to the sides, away from your cleavage line.  Thus, your cleavage will always be softer, or not as close together. In these cases, I recommend choosing a high profile implant because it has more projection , and less diameter.  The high profile projection will give you the most cleavage possible . In terms of the shape, the smaller diameter of a high profile implant will sit more upright on the chest wall and not go off to the side as much.

To learn more about the type of chest wall you have and how it affects your implants selection watch my video above or give us a call for an in person or virtual consult. And, as always, iff you have any questions you’d like answered here please post them below in comments.

Wondering if a Breast augmentation is right for you?

Contact Us to schedule your in-office or virtual consultation for just $30 (which gets applied to your surgery when you book). Or just give us a call at 410-494-8100! Note: Virtual consults can also be used to get second opinions.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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16 thoughts on “Some women get more cleavage naturally because of chest wall type”

  • Nellie says:

    Dear Dr. Rodriguez, Thanks for this video. I have pectus carinatum and I’m considering implants for a modest and natural looking augmentation. I was thinking about 275cc MP+ (which diameter is 11,7cm) because I like the size, but then, given that my BWD is 13cm, I thought I should get 300 MP+ because of its 12cm diameter. With pectus carinatum does the rule of choosing an implant with one or less cm less than your BWD apply? Or may be the diameter should be closer to 2cm with this condition? Mi stats are as follow: - size: A (80cm)looking to go to C - Bwd: 13cm - Distance between nipples: 20cm (I have a 5/6cm gap between breasts) - Contour below breasts: 67/70cm (70 when inhaling)
    • Dr. Ricardo L Rodriguez says:

      Nellie: To get a meaningful answer from me you would need a virtual consult with Skype or FaceTime where I could take a good look and discuss at length. But as a general rule, if you have pectus carinatum you need above all projection to have the implant rise above the sternum and give you some cleavage. For my carinatum patients I usually recommend High profile or extra high profile. BWD is a consideration, but projection is more important in your case. Contact Leeza at or if you need more info. Thanks for your interest!
  • Christine says:

    Hello Dr. Rodriguez, I recently had my second breast augmentation (13 years apart) from the same doctor and before hand we discussed going to a Large D or DD but now after surgery, I went from a small 34C to a 36C. There is more wideness to the breasts but no more projection. He says my chest indents inside due to my scoliosis that I had fixed when I was very young and the mod profile 400cc and 425cc was the largest implant that would fit. Just wondering, shouldn't the chest indention have been noted and he would have known before surgery? Also, is it really not possible to get any more projection due to this chest wall indention? Just looking in the mirror it is not noticeable but I guess when he was in surgery it was. The implants look nice and round with some cleavage but there is no projection and you really can not tell I have had them redone. Thanks for your time.
    • Dr. Ricardo L Rodriguez says:

      Christine: Implants come in all shapes. I think it is misleading to think in terms of "36 D" or whatever. The 36 refers to the circumference around your ches wall. That does not change, regardless of implant. The letter is the cup size. But different manufacturers and even different bra models within the same brand shape the cup differently. Likewise I do not focus on what "Fits" because many implant widths can "fit" depending on what look you want. My guess is I could very easily find a high profile implant to give you much more projection, even with the indentation in your ribs. Contact Kelly at for more info. We'd be glad to help you.
  • Tami says:

    Hello I have Pectus excavatum (Marfans) and will be having a bilateral Mastectomy in a few weeks and reconstruction later this year. I will be having expanders inserted. Intially my surgery was going to be a cordinated case however once the surgeon saw my concave chest he told me he was afraid that the implants would settle to the middle of my chest and form one boob; Is this possible? I'm nervous about future reconstruction now....
    • Dr. Ricardo L Rodriguez says:

      Tami: What you are describing is called Synmastia. It is a possibility. I think your surgeon is being cautious and waiting for your mastectomy and skin to hear as one continuous unit. This considerably reduces the chances of synmastia. Follow your surgeon's advice and trust him. He sounds like he is informing you of risks and taking appropriate measures to reduce them. Worst case scenario (and I don't think it will happen because your surgeon is very aware) you get synmastia...Luckily, synmastia is correctable. Get your reconstruction done as it will help your well being.
  • Amy says:

    Never knew there was an actually named for my condition. I am extremely concaved. I am 29 years old & have always been so conscious of it. I have never been able to wear a bra that fits normal. After 2 kids my breast have turned to pancakes:( now only if my husband wod agree with a breast augmentation. Just so glad to hear other women have this.
    • Dr. Ricardo L Rodriguez says:

      Amy: Most loving husbands think "I love her just like she is and she can be sure of my love" But you have to let him know that although you know he loves you no matter what this really bothers you and upsets you.
  • Kitty says:

    Thank you for sharing this! I considered getting implants when I was younger but I have Pectus carinatum. I always wondered why my breasts were so FAR apart and rest so much to the side. If I ever consider implants again I will take this into consideration! What would happen if I merely wanted a breast lift? Would my Pectus carinatum play a part in how this would be done also? I do not want to increase the size of my breasts really, but since I have had two children I would like them to be higher than they are now. Thank you.
    • Dr. Ricardo L Rodriguez says:

      Kitty: If you want fullness in the upper part of the breast, you really need an augmentation, even if it is a small one. A lift by itself will not give you fullness above the areola. And yes, we can place the whole breast complex higher up on the chest with a lift. We'd love to hear from you! Contact Kelly at
  • J. Hogue says:

    Dear Dr. Rodriguez, So thrilled to see this post. I have a concave chest and have wondered why my implants seem to fall to the middle and why I have such a hard time getting a bra to corretly fit. Don't really have any that fit properly. I often feel like I have a una-boob (one boob). I do have very deep cleavage but have trouble getting a bra to give lift and seperation. I am due for new implants as it has been 10+ years, could you explain the difference between high profile and moderate profile implants. I currently have 32DD but find that they have the appearance of a D or large C because so much gets lost in the 'hole' of my chest.
    • Dr. Ricardo L Rodriguez says:

      Ms. Hogue: Please look at this post on the difference between High profile and Moderate profile implant shape implant. From what you are saying, the fact that the implants have a narrow footprint may make them look smaller. You may benefit from a moderate profile implant that will give a wider appearance from the front and less pronounced cleavage in the middle. Of course, without seeing pictures I really can't make an educated guess, but I hope this helps.
  • Jenny says:

    Dear Dr. Rodriguez, I am 5'4, 110lbs, 20 year old woman with a pectus carinatum chest and I used to be an A cup until, I had a breast augmentation over the summer. Now, I have a small high profile B cup and Im not really happy! I hardly have a cleavage! I was just wondering if u recommend me getting another surgery in order for me to have a cleavage? Thanks, Jenny
    • Dr. Ricardo L Rodriguez says:

      It is really hard to get good cleavage with pectus carinatum. Your best option may be to get a bigger (more than a B cup) implant, either a high profile or a high profile plus. You need more volume than you think to overcome the prominence of the sternum. Other than that, it is hard for me to make a recommendation without seeing pre and postoperative pictures of your case. If you are interested, contact Kelly at
  • Michael C. Pickart, M.D., F.A.C.S. says:

    Thanks for posting this article. I am going to refer my patients to this explanation. Most women don't realize that the spacing between breasts is mostly a function of the width and shape of the sternum, of the locations of the origins of the pectoralis major muscle, and of the natural footprint of the breasts. Implants can only do so much!
    • Dr. Ricardo L Rodriguez says:

      Thanks for the comment. Nowadays patients come with a number of pictures pulled from other sites, with a result they would like. I find myself a lot of the time explaining chest type has a lot to do with result, which is why I posted this. BTW, saw your series of blogposts on breast aug and liked it very much too.