The active woman who desires breast enhancement usually has a slender and lean chest. The goals of breast enhancement for this population is a very conservative increase in volume and a very natural appearing breast that fits her frame and looks great in athletic apparel. The goal of the natural appearing breast augmentation is coupled with the goal of returning to athletic training soon after the operation. The key to achieving the goals of the active and athletic woman seeking breast enhancement is a moderate profile implant placed under the muscle, usually in the 300 cc range, depending on the woman’s height and weight. A silicone gel breast implant is the most natural feeling breast implant, which is important in the woman with a very lean chest. A saline breast implant should be used in the woman who is under the age of 22 in the United States. One of the main concerns in the active woman who inquires about breast augmentation is the placement of the breast implant over or under the muscle. Placement of the breast implant over the muscle does shorten recovery and eliminates any animation deformity of the breast implant when the pectoral muscle contracts. The main disadvantage is that placement of the breast implant over the muscle can lead to an unnatural upper breast contour and rippling, which is noticeable in athletic clothing. Placement of a breast implant over the muscle does affect the sensitivity of mammogram screening of the breast. The breast implant should be placed under the pectoral muscle, which gives a natural contour to the upper aspect of the chest, limits rippling and scarring around the breast implant, and has almost no effect on mammogram screening. The placement of the breast implant under the chest muscle does contribute to a slight increase in the recovery and the settling of the implants, but this is a minor sacrifice for a long-lasting natural appearing breast in the athletic and active woman. I usually recommend two weeks lay-off until cardio activity to help prevent bruising and swelling, and then 4 weeks to heavy lifting to allow for the pectoral muscles to relax and the breast implants to drop into a natural position. The placement of the breast implant, under the muscle should have no effect on chest strength and the ability to do upper chest and arm exercises. The reason for allowing the chest muscles to relax is that the chest muscles will be in a contracted position after the placement of the breast implants which does press on the implants and hold them in a high position. Allowing for chest muscle relaxation enables the implants to drop into the natural breast position. Breast implant massage is usually started within one week, which helps to break the contraction of the chest muscle. After three weeks the breast implants should assume a natural position and then after three months they will be very soft and move with the chest. My goal is that the woman forgets that she has breast implants in place. In certain circumstances exercises such as push-ups and swimming can aggravate the pectoralis muscle and lead to temporary firmness in the breast. This is likened to a “Charlie-horse” and will improve with massage and anti-inflammatories. Upper chest exercises should have no effect on the breast implants over time. I encourage my breast implant patients to follow-up yearly to check the implant, but with the new generation silicone breast implants, the risk of problems such as scarring or capsular contracture, as well as rupture is very low. Breast implants do not need to be routinely changed after 10 years; they only need to be changed if there is a problem; such as firmness, but more commonly for implant size change.
Breast enhancement for the athletic woman does improve the body as well as improving self-esteem. The operation and recovery can easily be incorporated into an active woman’s lifestyle. Please schedule a consultation with Dr. Trussler to help define the right breast enhancement for you.