Best Type of Breast Augmentation for Petite and Athletic Woman?

Hi, I am 5'1" tall, I weigh 115lbs. I am very healthy and active. I currently wear a 32 A bra. I have two children (breastfed). An average week for me consists of running 5x, gymnastics 1x, yoga 1x and strength training 1-2x. My doctor has suggested that with my lifestyle, I should get gel Breast Implants in the subglandular placement with 250cc. After reading everywhere, many doctors say that with such a small frame, the implant will be noticeable and I will have rippling. But my doctor says I cannot work out hard with submuscular? HELP! Afraid of golf ball boobs!

Doctor Answers (25)

Breast Augmentation for Active Women

I regularly perform breast augmentation surgery for patients who participate in body building, fitness and figure competitions. While many are initially concerned about sub-pectoral placement and the potential for distortion of the appearance of augmented breasts when the pec major contracts, I am absolutely confident that the aesthetic outcome for these patients will be far superior with implants placed under the muscle.
A pre-pectoral implant in a slender patient, especially one with well-developed muscles, looks just as you imagine it would: like a foreign object, not like a natural-appearing breast. The muscle does not have to contract for a pre-pectoral implant to look unnatural in this group of patients - it looks unnatural every minute of the day.
Achieving the ideal aesthetic position for a sub-pectoral implant requires release of part of the inferior origin of the muscle from the chest wall. I perform the minimal release of the origin of the pec major that is required to get the implant in an ideal position vertically, but also weaken the origin in the area where muscle contraction tends to displace an implant. As a result the vast majority of patients have little to no distortion of their breast appearance when the pec major muscles are tensed. Patients also do not experience any loss of function, strength or range of motion from release of this very limited part of the pec major origin. Many patients have indicated that their natural (but augmented) breast appearance has provided a significant advantage for them in competitions.

Web reference:

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 31 reviews

Sub glandular implants


As usual, there is more than one way to do a proceedure. I have been doing implants for over 30 years and have put them over the muscle and under the muscle. I find that silicone implants look great under the breast( over the muscle) if you are athletic and exercise, under the muscle can deform the breast when you exercise or use your pecs. You only get tennis ball breasts if you develope capsule contractures. There is no right or wrong answer -- but I am usually right.

New York Plastic Surgeon
4.0 out of 5 stars 8 reviews

Subglandular? submuscular?

I typically prefer placement under the muscle in patients with your characteristics as the muscle provides padding over the implant to camouflage it. Submuscular placement will slow you down just after surgery, but not in the long run. The best course is to make an appointment with a plastic surgeon to discuss the pros and cons of different types, sizes, and locations of implants. Good luck!
Los Angeles Plastic Surgeon
4.5 out of 5 stars 57 reviews

Sub Muscular Placement of Smaller Liquid Silicone Implants Would be Best Option for You


         There is no perfect solution to your problem and compromises are inevitable.  You’re athletic and muscular, which makes distortion of your implants likely when exercising if there placed under the muscle.  You have thin soft tissue and ripples, folds, distortion, and capsular contracture are possible when implants area placed on top of the muscle. 


         There is probably no right or wrong answer for this problem.  I believe sub muscular placement of smaller liquid silicone breast implants would represent the best option for you.  It is true that you might have distortion of your implants with muscle contraction, but this would probably not significantly impact athletic performance and this aspect of your life.  Smaller liquid silicone implants placed in a sub muscular position would also give the best aesthetic result. This combination would result in less rippling and a more natural breast shape.


         Your situation requires a detailed discussion with your plastic surgeon.  It is important that you know your priorities and that you understand the pros and cons of your options.

Omaha Plastic Surgeon
5.0 out of 5 stars 56 reviews

Conservative Breast Augmentation for Petite and Athletic Women





Your experienced plastic surgeon has suggested a sub-glandular  250cc. implant. 

Lean and athletic women, such as yourself, with smaller breasts can have visible augmentations. The amount of existing breast and the laxity of the breast tissue strongly influence the implant "visibility". The larger the implant, and the more the tissue must stretch, the greater the risk for rippling with a less appealing result.

Our patients with very well developed pectoralis major muscles and a small starting cup size are advised to select a pleasing, but not large, implant size for their enlargements.    We offer our athletic patients gel implants above their muscles to avoid issues of later unsightly implant displacement. In my opinion, this approach results in more consistent and pleasing results.

Hope this answers your question about having a conservative breast enlargement.

Best Regards,


Colorado Springs Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast implant placement


Orakle- Every woman’s body is different and because of that the only person that can talk with you about the size and placement of your implants is your surgeon. I prefer to place breast implants under the muscle as I believe it achieves a more natural look, less interference with mammography and minimizes the appearance of rippling. Talk with your surgeon in length about your desired results and voice your opinions and concerns.

Alpharetta Plastic Surgeon
3.5 out of 5 stars 4 reviews

Silicone gel implants (above or below the muscle) are preferred over saline implants in petite women.


Silicone gel implants look and feel more natural than saline implants in small thin women.  A recent study concluded that rippling with gel implants was no more likely above the muscle than below it.  I think your surgeon gave you good advice.  The only obstacle you face preventing a beautiful result is capsular contracture over which your surgeon has little control.  In my experience, about 1 chance in 25 that you will have a significant contracture.

Web reference:,13-atlanta-breast-augmentation.htm

Atlanta Plastic Surgeon
4.5 out of 5 stars 6 reviews

Pocket location for implants


In a very thin woman without a lot of breast tissue, I prefer to place implants under the muscle or what some call through a biplanar approach.  This gives more soft tissue coverage in the upper pole.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

Breast augmentation placement options for petite woman


It’s hard to say without a photo which placement fits you the best. There are various factors regarding how you want your breasts to look and feel, but if you and your doctor have a good, open line of communication, you shouldn’t need to go back and forth on your decision.

A major factor that effects how breast implants look and feel is whether they're inserted over or under the chest (pectoral) muscle. Traditionally I do a submammary implant, inserting the implants under the breast tissue and over the muscle through an incision in the breast fold. The result is fabulous: perkiness with barely a trace of scar.

If you want the most natural-looking breast you'll need a subpectoral implant, in which the implant is placed under the muscle. This procedure also requires the merest incision - about three centimeters in the crease under the breast or at the edge of the nipple -- and diminishes the incidence of capsular contracture, the formation of hard scar tissue around the implant which occurs in 10 to 30 percent of cases.

Subpectoral implants aren't right for everyone, though. If you have saggy breasts, an implant placed under the muscle won't fill out that empty breast sack, and you'll get what we call the "double bubble" look, where the implant is situated next to your armpit and the breast hangs several inches below it. Instead, you can have a procedure called augmentation mastopexy, in which the implant is placed under the muscle and the skin on the breast is lifted and tightened.

In short, you must know -- realistically -- what you are starting with, as well as what you want to look like when surgery is done. Do you want a natural appearance or a round, perky look? These are some of the factors I weigh with my patients when evaluating what type of procedure to do.

New York Plastic Surgeon
4.5 out of 5 stars 7 reviews

Breast Implants under the muscle for an active woman


Hi there-

Although when placed under the muscle implants MAY lead to distortion of the breast with exercise, this is only noted when the breasts are exposed (as in a tight tank top), and does not have implications for the longevity of the implants, your health or comfort, and does not affect the beauty of the outcome otherwise...

Further, when placed under the muscle, the appearance (whether during exercise or not) tends to be more natural and the feel of the breasts more soft.

Finally, the implants and your lovely outcome will last longer, and you will experience fewer risks, because of the protective effect the muscle tissue seems to have on the risk of capsular contracture and on the risk of stretching of the skin.

In my opinion and experience (I have multiple professional athletes as patients, and they all have their implants under the muscle), most women would prefer to deal with the minor possibility of some breast distortion with pectoralis contraction than with breasts that look unnatural AT ALL TIMES because the skin has been stretched by an implant on top of the muscle, or because the scar tissue has tightened around the implant.

Web reference:

Orlando Plastic Surgeon
4.5 out of 5 stars 82 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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