Wrinkles in the middle of the chest between the breasts, better known as cleavage wrinkles, are the bane of the well endowed. Today, I'll tell you about all sorts of treatments, including, believe it or not, Botox and fillers. Hello, I'm Dr. Neal Schultz And welcome to DermTV. All anatomically well endowed women at some time develop cleavage wrinkles. Whether your C, D, or larger cup size is on the basis of original factory parts, or from augmentation, the laws of physics eventually catch up, especially from sleeping on your side or from wearing bras that push your breasts up and together. Sleeping on your side causes the top breast to fold over the other causing a skin crease, while sports and push up bras also put mechanical stresses on the skin creating creases. Regardless of the cause of the skin creases, repeated and prolonged creases ultimately damage the collagen and elastic fibers in the dermis and cause wrinkles, just like on your face. There are many devices in the form of specially contoured sleeping tops that attempt to hold the breasts apart and avoid the mechanical stresses. Most look like bras or variations of them but are lighter in weight to avoid discomfort. Others are almost like round pillows placed between the breasts which are less like bras but may not work as well. The short term success of these wrinkle busters is immediately obvious after a nights sleep with less deep appearing winkles. But unfortunately, longer term improvement is not consistent. And another approach is a large silicone pad applied to the wrinkle area between the breasts, which holds the skin and prevents the gravity induced creases with variable success. Longer-term options do include the same gold standard filler injections like Restylane and Juvaderm used to improve facial contours. They can significantly improve cleavage wrinkles for up to 6 month or longer. And for some women, their cleavage wrinkles are also increased by muscle tension in their chest muscles. For them, Botox treatments can also help reduce wrinkles, but generally only last for 3 months. For some women with smaller breasts, cleavage wrinkles are considered a high class problem as they think they would happily trade having those wrinkles in return for larger breasts. Since they may not realize breast augmentation invariably leads to cleavage wrinkles, ladies, be careful of what you wish for!