The truth about the 'shelf look' and subfascial placement
It is a big misconception that subfascial placement leads to a shelf type appearance. True subfascial placement( where the fasciai is not violated and not burned into nonexistence actually does the opposite. Common belief and teaching is that placing the implant under the muscle adds superior pole fullness but I would contend that it does the opposite. If you have friends with submuscular implants and thin breast tissue, wantch their breasts- you will see that the pectoralis muscle is always under some tone, and variable tone. What this means is that the muscle tissue and skin are pulled down on the implant, creating a shelf like effect. the implants are always pushed down and out. The beauty of true subfascial implantation is that the fascia elevates over the superior pole, lifting the existing breast tissue away from the chest wall and blunting the edge of the implant. The problem is that some practitioners claim to perform subfascial augmentation when they are really performing subglandular or destroying the fascia with their dissection which is equivalent to subglandular. This is one of the many reasons that I developed the 'cold-subfascial augmentation.' The technique differs in that it is what i call a histiocentric technique. It pays respect to the tissues necessary for a successful operation by using precisely designed sharp dissection with no electrocautery or heat energy ensuring the full capacity of the fascia is present. A second important difference is implant selection. While almost everyone uses super high profile implants. In reality with an intact and carefully designed fascial dissection a low profile implant can be designed to project and taper as a beautiful teardrop shape. I prefer to shape the breast in this manner to attain a soft and projecting natural appearance. I hope this helps!
All the best,
Rian A. Maercks M.D.
Silicone gel implants under the breast can be good for athletic lifestyle
Submuscular implants can create distressing motion during exercise and activity.
Since you want a small natural look and are entering basic training where you will be doing vigorous activity, i would avoid the submuscular and subfascial locations.
A 240 cc new gel implant placed beneath the breast (subglandular) will, in my opinion, give you the most natural, normal look and avoid distressing muscle movements of the implant. Displacement exercises and masage post op are important to soften the breast and help prevent capsular contraction. Meticulous surgical technique is also important.
Avoiding bleeding during surgery is important to help avoid capsular contraction. In my opinion, the submuscular and subfascial techniques do result in more bleeding than a carefully done subglandular procedure.
Discuss this with your surgeon.
See before and after photos of breast augmentation.
How will breast augmentation surgery effect the lifestyle of an athletic woman?
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.
Breast implants probably won't affect athletic lifestyle
It sounds like you chose relatively small implants. I find that athletic patients have more interruption of their activities when they go for larger breast implants.
You could choose to have them placed "over the muscle," which tends to interact with the muscle function less. Smaller implants are not as much of a problem when placed "under the muscle" however.
If you do go with "over the muscle" placement, the issue would then become how will they do over the long term. Silicone implants "over the muscle" tend to have more contracture (breast hardening) over the long term.
What you will find is that most of your choices regarding breast implants are a matter of trade-offs that you should sort out with your surgeon before you have your surgery. One of the things you get with a good surgeon is experience and advice.
Most likely will not effect your lifestyle
Even though you are atheletic I would prefer a partially sub-muscular placement because you are thin and a more natural look is achieved this way. To me the sub-fascial placement is essentially the same as sub-glandular. Some plastic surgeons swear by it but I prefer a thicker coverage. The size you have chose n should suit you well in terms of dimensions and volume. Best of luck.