Athlete with Large Pec Muscles Looking for Natural Breast Augmentation.

I am very athletic, I work out 6-7 days of the week (muscle training on at least 5 days weights & TRX) I would like breast augmentation, my breasts are truly just loose skin from being larger & then weight loss, there's no fat-this is the only place on my body with this issue (I wear a 36 B,a smaller size skin would push out sides/top of bra). I don't want to lose any of my abilities in athletic side & just want to fill the skin not oversize. I am good with silicone, not sure on the placement.

Doctor Answers 24

Implant placement in athletes

I have found that submuscular placement in athletes and body builders results in undesirable muscle movement,where as sub glandular(above the muscle) does not offer sufficient coverage, as these patients have very little fat.The result is usually an abnormal appearing breast

Over the last few years I have been placing the implants under the fascia. In extremly thin patients I will add dermal grafts to add further support

.Results with this technique have been most gratifying

Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Athletes pose special issues for breast augmentation

For many athletic women, like yourself, breast augmentation can still be an excellent option. The main issue that most of the comments above address is the placement of the implant; whether it should be in front of or behind the pectoralis muscle.  Most plastic surgeons in the US would recommend sub-muscular placement because of the lower rate of capsular contracture. If you are concerned that placement below the muscle may hinder your athletic activities or be visible when you contract the muscle, then you might want to consider discussing this with your plastic surgeon.  

Sub-glandular breast augmentation (in front of the muscle) is still commonly performed in Europe and for select patients in the US.  There are other issues that your surgeon might discuss with you if this is your preference.  These include, capsular contracture, numbness, implant edge visibility, and palpability of the implant.  Your surgeon should be able to discuss the pro's and con's of implant placement to help you make an informed decision. Good luck to you. 

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
4.9 out of 5 stars 70 reviews

Breast augmentation in athletic women

There are several things to consider here – amount of loose skin, size of implants you desire and how much of your workout involves your pectorals.  With very little breast tissue to cover the implant- under the muscle may give you the best result, but may interfere with your workouts.  Silicone implants are less likely to ripple and may be more natural in a woman with very little body fat.  Good Luck!

George John Alexander, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 38 reviews

Natural appearance with breast augmentation

Based on your information, I would recommend implant placement under the muscle with a moderate sized silicone gel implant.  An implant above the muscle is more likely to result in visible rippling unless you have a rather full breast to start with.  Silicone gel implants are more natural in feel, which is an advantage in slim individuals, or women with minimal breast tissue.

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon
4.9 out of 5 stars 23 reviews

Placement site?

Submuscular placement is still the best option for you. It will prevent rippling, reduce the risk of capsular contractor and does not interfere with mammogram. Given all these advantages I would choose submuscular placement for you. Good luck 

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Natural breast augmentation

Because you have minimal breast tissue and body fat in general a subpectoral augmentation would be prefered. This puts more tissue between the implant and the skin and typically results in less risk of capsular contracture. Also, with a saline implant, the subpectoral muscle approach will result in less chance of visible or palpable rippling. With your anatomy a gel implant may give the best result.

David A. Bottger, MD
Philadelphia Plastic Surgeon
4.9 out of 5 stars 56 reviews

You should have them placed under the muscle

For the most natural look, you should go under the pectoralis major muscle.  Even if you have strong muscles and love to work out - this greatly decreases the rate of capsular contracture (bad scar tissue formed around the implant).  You will not notice a difference in your body building after you are all healed.  I often place subpectoral implants in body builders who do great.  Good luck!

Bivik Shah, MD
Columbus Plastic Surgeon
4.4 out of 5 stars 26 reviews

Breast implants and bodybuilding

Never having seen or examined you it is impossible to say what would be best in your situation. Female body builders in general have little body fat and the process can also melt away breast tissue. Refilling the breast skin envelope is then challenging in this situation because there is so too little fat or breast tissue to cover the edges of a breast implant placed on top of the muscle. So saline implants above the muscle is out of the question. Implants placed under the muscle are even more problematic because the pressures or forces applied to them during weight lifting can rupture the implant or more commonly shift them out of position. I saw one patient who while bench pressing squeezed her implant out of position so it formed an unsightly U-shape around the lower border of the pectoralis major chest muscle.

The only answer although not optimal is a cohesive gel breast implant placed on top of the chest muscle and in selective cases the addition of acellular dermal matrix to ensure the edges of the implant and rippling are not visible, although that is costly and is not be the right choice for all such patients.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast Augmentation in Athletic Woman

I have done many people like you and gotten very natural results. I recommend textured Silicone Implants on top of the muscle. The texturing keeps them feeling soft and the Silicone makes them as natural feeling as you can get. Since the fascia is so thin, I have found no advantage of trying to elevate it. Putting the implant under the muscle risks exactly what you wish to avoid.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Sub glandular silicone gel implant is the best choice for you

In a body builder with large pectoralis Major muscles, a peri areolar sub mammary silicone gel implant would be my recommendation. As you well know the problem with sub mammary placement in patients with limited breast tissue and soft tissue is the problem or ripples. While all implants ripple, gel ripples less. It is not a question of rippling so much as to can the ripples be seen or felt. If they become a problem then fat grafting over the areas of rippling has worked well for me. Even in thin women I have been able to find some fat in the medical thighs but if you are very thin then it may not be adequate. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 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.