Breast Implants - What Kind Are Best For Active People?

Hi. I am 18 years old, 5'4, and 104 lbs. My bra size is a 34A. I would like to be a full B cup, or a small C. Any sugguestions on the placement or which kind to go for, saline or silicone? I also like to be active, run, etc. Any advice would be greatly appriciated.

Doctor Answers 20

Breast Implants for Active People

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You may be as active as you wish with saline or silicone implants. There are however a few suggestions that I can make:

  • with your height and weight (5'4" and 104 lbs) you will do better with sub-muscular implants
  • smaller implants will be less likely to interfere with sports and running

Your surgeon can provide you with sizers to try out. Only you can decide what size will come closest to meeting all of your goals.

Columbus Plastic Surgeon

Breast Implant choice

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The best implant for you should be the one that fits your body. You should consult with a board certified Plastic Surgeon. You and your Plastic Surgeon should pick an implant based on your body and breast size after trying several implant sizes. As an active person, the implant  should not be too big, as bigger implants tend to give more issues in the future. I recommend placing the implant under your muscle. You are not eligible for silicone implants due to the age restriction by the FDA. Your only choice is saline breast implant. Good luck.

Breast Implants are for life, not just a few years. Consider the results you want long term

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A saline augmentation is certainly an option for you, but there are some additional issues to consider.

One is the fact that, at age 18, you may not have completed breast development. Many women experience a natural increase in breast volume after age 18, and it certainly would be frustrating to have breast implants placed at your current age and then experience a one- or two-cup size increase in your natural breast volume some time after the augmentation surgery. While it is a minority of women who experience this late teens/early twenties increase in natural breast volume, it is enough of a concern for me to have a policy in my practice of offering implant-based breast augmentation only to women age 21 and over.

My recommendation to you is that you wait until you are 21 or older to have your breast augmentation surgery. And here's another great reason for you to wait, and to wait even a year beyond your 21st birthday: at age 22 you become eligible for cohesive silicone gel implants, according to the FDA's current guidelines. A slender patient with A-cup breasts does not have much natural tissue to conceal a pair of breast implants, and you will without question get a result that feels much more natural with cohesive silicone gel implants compared to saline implants.

Regarding your concern about your active lifestyle: I think that your interest in a 'full B to small C' breast volume is ideal, as a full C to D-cup breast volume will probably make you look top-heavy at 5'4" and 104 lbs. Also, the weight of larger implants will tend to stretch out the lower pole of the breast over time if you exercise frequently, particularly if it is impact exercise like running. The implant volume that will produce a full B to small C for you is most likely in the 270-330cc range, and the implant style that will look most natural is a low- to intermediate profile implant. Regarding implant position, I think all breast implants should be placed in a subpectoral position - it creates a much more natural upper pole appearance, especially in slender patients with small breasts, and it makes the breast easier to image by mammography when you reach that age.

While you are waiting, you may want to gather some information about another means for breast enhancement that is rapidly gaining popularity: structural fat grafting. This technique involves the transfer of your own living fat tissue from a remote location (thighs, hips, abdomen) to the breasts to permanently increase breast volume. This generally produces a one-cup breast size enhancement, and thus you might expect to go from an A cup to a full B cup with this procedure. If you are truly interested in a C cup breast volume, you probably should select an implant-based breast augmentation. There is a technique described for using suction cup breast expanders prior to fat grafting in order to produce a two-cup size (A to C) augmentation by fat grafting, but the results that I have seen presented at scientific meetings were not aesthetically ideal in my opinion; the breasts tended to be elongated and slightly down-pointing - which is certainly not the appearance you are aiming for in your twenties. As with implant-based breast augmentation, I also limit breast enhancement by structural fat grafting to patients age 21 and older.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Breast implants for active young woman

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For a 18 year old active woman a saline implant is recommended. Breast augmentations placed under the muscle gives good soft tissue coverage for a more natural look, and can make mammograms more easy to read . Choose a size that fits your chest. Your plastic surgeon will help you with this. You will have a range of sizes to choose from. Be conservative if you are very active. It is hard to be very active with very large breasts.

Implant selection

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Younger than 22, you can only get saline.  I recommend under the muscle, smooth, round, though others may disagree.

Saline Breast Implants for 18 Year Old Patient

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At your age of 18 only saline breast implants can be offered to you by a restriction placed on manufacturers by the FDA. You must be at least 22 years of age to be eligible for silicone breast implants. With saline implants, you may have them placed through an armpit incision to have a hidden scar. With your body frame and an active lifestyle, you would want to keep your fill volume to no more than 300 to 350cc . This will keep you in the low C cup range

The best implants for active people!

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In general, slim athletic women such as you do best  with implants that are not overly large, so asking for a large B or small C cup in size is just right, in my opinion. The exact size would be dependent on your breast base measurements and your exact anatomy of the chest wall, muscles, and breast tissue at the time of surgery. In our office surgical facility we maintain an inventory of each implant size in all three profiles so we are not handicapped by having to pre-order certain sizes or profiles--we have everything on-hand so we can always use exactly what our patients need rather than what we have preordered.

With a slim patient who has little of her own breast tissue, there is less implant coverage, so implant edges or ripples are more common. Thus, many plastic surgeons would recommend sub-muscular placement to help give a natural, smooth look and feel. When everything heals, muscular function is normal, so this is not an issue, but some patients may have distortion of the lower inner region of the breasts with pec muscle contraction. Fortunately, this is relatively uncommon, and I even have bodybuilders with sub-muscular implants.

Use of silicone implants in a woman under the age of 22 would be considered "off-label" use, just as using Botox for crows feet is "off-label" (Botox is FDA-approved ONLY for treatment of glabellar frown lines, though most physicians have no problem with "off-label" use in other areas.) I personally feel that the latest generation of cohesive silicone gel implants represent the best, safest, and most natural implant I can offer my patients regardless of their age, and if informed consent is given, I always prefer to do what is best for my patient.

Saline Implants, even when properly filled, can leak and deflate, requiring re-operation to replace the implant. There may be a tendency to see implant edges and ripples (even with optimal filling), particularly in a thin, athletic woman with less of her own tissues to "cover up" her implants. The newest generation of silicone gel breast implants are cohesive and cannot deflate, rupture, or leak, and my patients who have had saline implants replaced with silicone implants uniformly tell me that they like the "feel" of silicone gel implants better than saline. There is also a more homogeneous quality of the silicone-implanted breast as compared to the saline-augmented breast--it is more soft and natural, whereas the saline implanted patient may sometimes feel like her breasts are her plus "water balloons." This may be particularly true in active women whose breasts "move" more.

I would recommend moderate profile implants, which give the widest base and the least projection, particularly when a smaller implant is chosen. A 200cc silicone moderate profile implant has a 11.7cm base, which is likely too narrow for your breast base measurement. 300cc or so may be better, helping to avoid the "baseball in the bowler hat" appearance! Final size choice is determined in consultation with your surgeon, and depends on all the factors discussed above. Best wishes!

Avoid very large breast implants.

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1) Particularly for active women, it's best too avoid too large implants.  I would guess for you, 200 cc's would be about right.

2) I would recommend round, smooth-walled, silicone implants under the muscle.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Breast Implants for Active Women

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At your current age of 18 saline implants are your only choice.  I think all most all patients, regardless of their activity levels, get better results when their implants are placed under the pectoralis muscle.  This is even more important with saline implants as they are more inclined to ripple a bit.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Breast implants

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At your age, you qualify for saline implants only.  The size:  probably: 300-330 cc.  Remember, if you get too large of an implants, you may experience some distortions due to the fact that you don't have much tissue over the implants.  You can resume your normal activities (exercising) following approximately 2 months.

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.