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 (27)

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.

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 41 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.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 9 reviews

Best Type of Breast Augmentation for Petite and Athletic Woman?

The majority of patients who undergo the breast augmentation procedure will be able to return to full activity without restriction, over the long-term. You may find the attached link, dedicated to patients "in competition” helpful to you. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 726 reviews

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Submuscular, Silicone Cohesive Gel Breast Implants For Athletic Woman

Fitness models and athletes almost always have greater muscle mass than non-athletic patients. As a result, breast implants are typically placed underneath the pectoral muscles (sub-pectoral placement) to ensure a natural-looking outcome.

Increased muscle mass also means that implants should be sized in proportion to your body. Rather than simply selecting larger implants, I recommend implants with specific profiles. Years of strength training and fat loss mean that you probably have lost upper pole breast mass, volume from the breast's superior and superior-medial poles (this can visualized as 8 and 12 on an analogue clock) and general breast fullness.
The implants must also be chosen in proportion to the dimensions of your chest wall. One of the most important goals of the procedure is to create great cleavage by using wide diameter implants without leading to a unified-looking breast (symmastia). I carefully measure your chest wall before selecting implants based on these figures to maximize cleavage and leave behind a pleasing, natural-looking result. This approach works well for all patients, regardless of whether they wish to enhance their bust size by a small or large amount.

At the six week point it's possible to gradually return to low weight, high repetition resistance training aimed at the upper body, reconditioning the weak, tightened pectorals and shoulders. Patients should start with upper body exercises such as light dumbbell bench presses and kneeling push-ups, then work their way up from there.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 59 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!

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 67 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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 78 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,


Douglas J. Raskin, MD, DMD
Colorado Springs Plastic Surgeon
5.0 out of 5 stars 26 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.

Joseph G. Bauer, MD
Alpharetta Plastic Surgeon
4.0 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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 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.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 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.