What sort of breast implant make, style, size, and incision is best for a very athletic woman? (photo)

Athletic, 31 yr old, 34A, 5'5, 120 lb, LEO want to be D cup, but go back to weight lifting (5 days/wk for 13 yrs), insanity/plyo, etc. I don't want my implant look to change much after surgery (don't want softball look). Also still want kids & to breast feed. I've had multi consults...some say under some over (after I press that I want to weight lift again), all docs say silicone but they mention HP, Mod +, or form stable "gummy" (will it shift?). All say incision under crease.

Doctor Answers (7)

Resolving different surgical opinions

+2
It is confusing when different doctors offer different opinions. Being well informed yourself, you, like most patients, can usually determine what is best for you. 
Based on your pictures and information, not a thorough consultation, I would tentatively recommend moderate profile Natrelle cohesive gel implants, size 371 or 397 cc most likely. I also strongly favor under the muscle placement, even in body builders, fitness competitors, etc. 
See my website for some patients with similar physiques. I hope this helps. --Dr G. 


Cleveland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast aug in athletic woman

+2
Hi Lexi,  As you have found out through your consultations there  are many options available.  First and foremost going up to a D cup is not a really good idea in someone as active as yourself.  Probably better to go small C range. This will still give you a noticeable enlargement and not interfere with your activities. The position of the implant is usually beneath the muscle, which has less likelihood of showing ripples and of forming scar tissue.  The main negative is it will have what is called a motion defect, or the muscle contraction will move or slightly deform the implant.  Most women are not bothered by this however it is something you need to know about to choose what position you want to place the implants.  As far as type silicone in a thin person will give a better result with less palpability and less rippling.  The style,  high profile or moderate profile is determined by the dimensions of your breast.  Gummy bear, or form stable are slightly firmer and more costly and yes they can shift so I don't think they are worth the extra cost.  There is a lot to think about but your surgeon should take the time to discuss all of these things so you can make a well informed decision.

William H. Sabbagh, MD
Detroit Plastic Surgeon
4.5 out of 5 stars 13 reviews

Smaller breast implant better for very athletic woman

+2
Thank you for your question and photograph.  You have very attractive normal looking breasts.  My big concern is that you want a D cup breast which may well look too big on your toned body and could interfere with your athletic activity.

You will need 3-4 weeks before lifting weights if you have a sub-muscular breast augmentation.  There are many benefits to having the implant placed beneath the muscle and in my experience this does not create a problem for active athletic patients who lift weights unless of course they are competing in weight lifting competitions with a bikini top. Generally speaking moderate profile plus smooth-walled silicone gel breast implants in my experience create the most natural look.

Please consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in breast augmentation surgery, and who has an excellent reputation in your community.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
4.5 out of 5 stars 31 reviews

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What sort of breast implant make, style, size, and incision is best for a very athletic woman?

+2

Thank you for the questions and picture. Despite your good description of your body type and goals, online consultants will not be of specific enough help to you. Generally speaking, I prefer the use of the sub muscular (dual plane) positioning of breast implants for the vast majority of patients (including athletic patients) seeking breast augmentation surgery.   I think that the outcomes associated with this positioning tend to be better long-term and associated with fewer downsides. Also, generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as  “natural” or “C or D cup”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

 The use of computer imaging technology may also be very helpful during this communication process.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this, and the attached link (dedicated to athletic patients\) help.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 727 reviews

Submuscular, Silicone Cohesive Gel Breast Implants For Athlete

+1
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

Dr. Kayser

+1
You always have a number of options with regard to implants and each have their own pros and cons in addition to the placement of either above or below the muscle. Another option would be fat grafting and although your body fat will not let you be the size you are stating, a smaller breast that's all your own material (fat) and totally natural may not be a bad option.  There is also the ability to combine fat grafting with an implant placing it above the muscle to better cover your implant and use a smaller, more natural one as well. I hope this helps and have a wonderful day! Dr. Kayser - St. Clair Shores

Melek Kayser, MD
Detroit Plastic Surgeon
5.0 out of 5 stars 11 reviews

On Athletic patients many aspects should be considered...

+1
Hello, 

Thanks for your question. 

I had a similar patient once who was a professional and olympic runner so I totally understand your concern.

This has a lot to do with what type of breast do you want. Let me explain myself:

- For an extremely natural look (meaning looking like you had them all along just bigger) I'd recommend an Anatomical Shaped implant (aka Teardrop). Pros: can be placed between breast tissue and muscle (I'll explain later why this is a pro in you case), will give you a very natural look. Cons: you won't have a full cleavage without a bra or bikini, upper pole will not be as filled as it would be with a round implant. 

- For a more breasty-round look (meaning your breasts will look round) I would recommend you a Round Shaped implant. The key point here is that (because of your pectoralis muscle definition and the lack of fat between skin and muscle) the plane would have to be a sub-muscular plane. I use a lot the sub-muscular plane but in patients like you that will continue having a very athletic body, the muscle could press against the implant when you do weights and may not have the aesthetic look you want. Some surgeons may argue that they detach the muscle well enough so it doesn't mark, but intensive trainers (like you seem to be) end up working well the rest of their chest muscle and may end up compressing the implant. Round implant on top of the muscle here is not an option, as you'd end up having that undesired result you mentioned ("soft ball look").

Bottom line: for very fit athletic patients like you, big implants are not recommended if they do not want them to be marked on their skin (not to mention they will get in your way for running and aerobic exercises). You can have a good size (I'd say max a C cup) and not have your breast get in the way of your exercise routine. Incisions? Totally agree with inframammary incision (under crease). Breastfeeding? None of both planes affects breastfeeding. Profile? Medium - the more you project the implant forward the more it will mark on your skin. Medium is an ideal profile for patients like you. 


Hope this explanation works as a light for your doubts. 

Take good care of yourself, 

Dr. Fernandez Goico

Luis A. Fernández Goico, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 20 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.