The Surgeon Minute

Breast Augmentation in Very Fit Patients

Breast Augmentation in Very Fit Patients

The majority of female body types and the average female size work very well with modern breast augmentation. In fact, those with some breast tissue already and a healthy weight (not skinny, but not overweight) tend to be the best candidates. They have just enough fat and/or tissue to comfortable seat an implant, helping smooth edges and providing a “padding” of sorts to the finished result. This can be frustrating to one subset of the female population, a group that is one of the most challenging to perform breast augmentation on: athletic, fit women.

For the woman who has worked tirelessly in the kitchen, gym, and on trail for a body near perfection, the fact that her accomplishments have in some way hampered the possibility of a great breast augmentation is troubling. The woman who compete in CrossFit, weight lifting competitions, or are long-distance runners tend to have very little body fat, a sleekness that makes natural-looking breast augmentation a challenge.

The most exciting things for these would-be patients is while it remains a challenge, modern breast augmentation has made it a realityDr. Melinda Haws of Nashville, an expert in breast surgery, sees a lot of these “work out mavens” in her practice. She discusses the questions to consider if you are a very fit patient who would like some more volume in your breasts without looking as if you have breast implants.

Breast Augmentation in Very Fit Patients

Women are embracing extreme fitness, and it’s a step or two beyond most people’s regime of Soul Cycle and yoga. The patients who participate in high-intensity weight lifting or exercise often have a body fat percentage as low as 10-12%. “For them, a breast augmentation can be challenging,” explains Dr. Haws. It’s not as simple as just sticking in a breast implant. Thanks to the patients’ limited body fat, they tend to have very little soft tissue coverage. Since this is what camouflages the breast implant, especially around the edges, this can be a problem. Complicating matters further, extremely fit patients are also the patients most interested in natural breast augmentation. Overcoming the challenge involves selecting the right implant, the right placement, and, of course, choosing a surgeon well-versed in the specific procedure.

Over vs. Under the Muscle

Dr. Haws has found that the best breast implant choice for her very fit patients is one of the more cohesive gel implants. Sometimes she will choose one that is shaped, and sometimes she will pick one that is round. The right option is really going to depend on the individual patient’s needs and anatomy.

Implant placement.

The more difficult question is whether to place the implant over or under the muscle, each having its pros and cons. The main advantage of under the muscle placement is that it tends to look more natural. Under the muscle does mean a longer recovery, which may be a factor of import for the athletic patient. While the recovery for very fit patients is shorter than that for the average patient, you still won’t be able to do chest work for about 3 months. Over the muscle placement has a faster recovery, but it doesn’t always deliver as natural looking results.

Fat Grafting to Create Soft Tissue Coverage

In general, Dr. Haws recommends that patients look at their friends who have breast implants or check out other women at the gym. Some women’s implants move a lot when they’re under the muscle while others move very little. However, animation deformity, which is the term for this implant movement, can be a much bigger deal in heavy weight lifters. It sometimes looks down right scary. Fat grafting is here to the rescue.

“Things have gotten so much more advanced in our science and our literature about doing fat grafting – not necessarily to make the breast bigger, but to give more coverage in the upper pole of the breast,” says Dr. Haws. The fat grafting procedure is really a two for one. The surgeon will use liposuction to remove fat from an area where you have too much. Since not a large quantity is needed, this is a viable option even in very fit patients. This fat is then cleaned, spun and re-injected into the breast to soften out or hide the edges of the implant. This allows surgeons like Dr. Haws to offer her very fit patients the option of a breast implant over the muscle while still delivering natural looking results.

Breast Augmentation Recovery Different for Very Fit Patients

When Dr. Haws sees her “work out mavens,” their restrictions following a breast augmentation are a little different than the average patient. She will typically allow these patients to start getting their heart rate up as early as 1-2 weeks post surgery. She does not want you doing heavy aerobic activities, especially anything that involves a lot of bouncing, for at least 3 weeks.

The bigger deal is chest work. If your implants are placed under the muscle, Dr. Haws does not want those implants to move. Your chest muscles can’t push them too far out or down for at least 3 months. This means no heavy pectoral activity or heavy chest workouts during this time. Otherwise, you can do anything that you want by 3 weeks.

With very fit patients, it is vital that you see a plastic surgeon who is full service. You want someone who will offer you the option of breast implants with fat grafting to the upper pole and edges to really create a natural look. Choosing a board certified plastic surgeon with a special interest in breast surgery means that you are getting someone who is familiar with all the different implant manufacturers and who can tell you exactly the best option for your individual needs.

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