I have been considering breast augmentation, however I may have a few more issues than the "normal" patient. I have had a few fibroadenomas removed leaving a noticible dent in my breast when i lift my arms. Also, I am an avid weight lifter (not professional) and rely on some physical strength for my work, some of it consisting of chest muscles. I have fluctuated from a B to C cup (now B) but my breast are fairly low due to weight fluctuation and genetics, I would like a D cup. Suggestions?
Possible Breast Augumentation Issues
Doctor Answers 8
With weight lifting you may need to consider textured implants and placing the implant on the top of the muscle/subglandular if you want to avoid the rippling/indentation look of the muscle compressing the implant with the submuscular approach. You need to see a Board Certified Plastic Surgeon to obtain your options and possible outcomes. This is not a surgery for an inexperienced surgeon.
With the multiple issues that you describe, it is always best to have a physical exam and discussion with the doctor. if you have depressions from the biopsies, it probably will not significantly improve with implants, but the implants will make the breasts larger.
Breast lift and breast implants
Without photos and/or a physical examination it is impossible to know what would be best in your case. With the changes in bra size you describe and your breasts being fairly low it is likely you will need a breast lift in addition to augmentation. Your situation is complicated by the dent you describe and the fact that you are a body builder. I would assume you want the dent addressed rather than just making the breasts larger. Lacking more details it is impossible to know if different sized implants on each side will suffice or if the breast tissue needs to be manipulated in some way to treat the dent.
Given your situation I highly recommend against trying to get a D cup result. If you think your breasts are low now just wait till a large breast implant has been in there for awhile especially if it is placed above the muscle even if you undergo a breast lift at the time of augmentation.
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.
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Without pictures or examining you in person, it is impossible to give you specific advice. In general, under the muscle silicone implants give the most natural result and have the most tissue coverage. However, if you have sufficient breast tissue, then above the muscle may be a possibility. You may also need fat grafting to contour the lumpectomy defect.
May benefit from combined fat grafting and implant augmentation
Possible Breast Augumentation Issues
Unless you are a determined body builder than the muscle split or sub fascial placement are good options. But if you are truly serious lifter than above the muscle placement is better. As for the post op dent I recommend fat grafting at the time of implantation.
Breast augmentation issues for weight lifters
Women who do weight training have particular issues with implants, and often a split muscle or subfascial technique is worth considering. The problem is that when body fat is low breast implants above the muscle look fake but under the muscle can have problems of what is called animation deformity, which is a distortion of the breast shape with muscle flexion. At least 3 out of 4 women with submuscular implants using the standard technique will have some degree of animation deformity because of how the muscle is cut. The split muscle method uses the upper part of the muscle to cover the implant but leaves the lower part behind, so animation is minimized while coverage is maintained where it is most needed. Also, the muscle does not have to be cut from its normal attachment. Subfascial is another option to consider. The best advice is to be vary careful about going too large regardless of the technique. A small amount of fat grafting might help fill the dent from the fibroadenoma. There are a number of important decisions here so take your time and learn as much as you can.
Complex breast augmentation issues
You do have a tougher than usual starting point, but fortunately you seem aware of that. The description you give leads me to believe you might need a lift as well as implants. Going to a larger size, though, complicates the matter and increases the risks especially when a lift might be involved. The fibroadenomas present another problem in that they may continue to be an issue in the future not to mention the deformity they have already caused in the breast. This is one of those cases not for a rookie plastic surgeon and I would encourage you to visit with the best WA plastic surgeons for an in person exam and thorough discussion of all options, alternatives, and risks.
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.