In women that are muscle builders and do extreme bulking, implants below the muscle can be a problem. Most other athletic women will do better to put the implant below the muscle. I ask my patients not to emphasize the strengthening and bulking of the chest muscles but they can do everything else they desire.
With your petite status and thin tissue coverage I would recommend the silicone implants. Be wise with your size selection and you should get a nice result. (Marcus L. Peterson, MD, Saint George Plastic Surgeon)
There is not an ideal breast implant that is one-size-fits-all. Also there is not one technique the is appropriate for all patients. The decision really depends on the evaluation and in consultation with your plastic surgeon.
If you post pictures, we may be able to give you more specific advice. (David Shafer, MD, New York Plastic Surgeon)
I recommend smooth round high profile silicone implants. As for the placement in a VERY active athletic woman. If placed under the pectoralis major muscle you have 2 main issues. The first, you will not be able to ‘work out’ for 3 to 6 weeks, bummer. Second, when you do exercise the implant by the action of the pectoral muscle will shoot laterally toward your armpit. Versus above the muscle placement can look a little unnatural but with extreme exercising there should be no lateral displacement. Second, you will be able to return to activities in half the time. I discuss this in extreme detail with the athletic women wanting implants, this is giving good informed consent. In my personal experience the majority like the above placement. (Darryl J. Blinski, MD, Miami Plastic Surgeon)
The IDEAL Breast Augmentation in a thin athletic woman
While I agree with the use of silicone gel implants, I respectfully disagree with your surgeon. ALL breast implants ripple with saline filled and textured implants rippling more than smooth or gel filled. For this reason, the vast majority of implants are best placed under the muscle NOT over it. (The “golf ball” or “melon” look is the classical result of poor cover over encapsulated (IE scarred) over the muscle implants).
In my opinion, the best look and natural feeling results would be with appropriately chosen silicone gel implants placed under the muscle. If you wanted larger implants, the inferior and side of the implants may be covered with an Alloderm or Strattice sheet to provide support and hide the rippling from the outside. (Peter A. Aldea, MD, Memphis Plastic Surgeon)
Best location of breast implants in a small, physically active woman
Breast implants are placed below the pectoralis muscle for a variety of reasons. The incidence of capsular contracture is lower and the muscle is an additional layer draped over the implant so that the implant is less visible. The downside of this placement in a thin, physically active patient is that the implant will be squeezed by forceful use of your pectoralis muscle.
Once you have healed, this squeezing will not disrupt or damage the implant, or move it out of place, but using your pects will make the breast appear to move. This is not usually visible through clothes, but can be visible when bare. In my practice, most of my patients don’t mind this, but I always tell them that this is a possibilty. I have patients who are weight lifters and manage just fine with submuscular implant placement. Placing an implant above the muscle in a thin patient can allow the implant to be visible, particularly if the implant is bigger than your skin will easily accommodate. It is always worth getting a second opinion with another surgeon certified by the American Board of Plastic Surgery.
I would also advise you to experiment with different implant sizes so that you are choosing a size that suits your needs. I guide my patients to help them pick an implant size, I never choose the size for them. (Elizabeth Slass Lee, MD, Bay Area Plastic Surgeon)
Breast Augmentation for petite, athletic woman
I think that you will achieve your best result with a silicone implant placed beneath your pectoralis muscle. I agree that you will be more likely to have some rippling which is visible if your implant is placed in the subglandular position. You must be prepared, however, for a period of at least 3-4 weeks in which you refrain from your vigorous workouts. (John Whitt, MD (retired), Louisville Plastic Surgeon)
Breast Augmentation placement
I am not a fan of above the muscle placement due to the higher likelyhood of palpability/visibility, contractures, sagging,though it is an acceptable option. On the other hand, under the muscle may be an issue if you do a lot of pec work (implants will jump up).
I would still consider under, as the benefits, I believe outweigh the down side. Silicone implants are a good choice, and 25 to around 300 seems to be a good range for you, and will allow you to continue your activities. (Scott E. Kasden, MD, Dallas Plastic Surgeon)
Over the muscle breast implants good for very athletic women.
250 cc’s might be a litte large for you, but otherwise your doctor’s plan for your breast implants is good. Moderate plus profile, round, smooth walled, cohesive silicone gel implants should feel natural and hardly ever ripple. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)
I would suggest submusculr silicone implants. The size will depend on the amount of skin and breast tissue and your breast base diameter. (Kamran Khoobehi, MD, New Orleans Plastic Surgeon)
With the athletic lifestyle you describe, I agree with your doctor that sub glandular positioning of the implants is probably the best option. You can avoid the “golf ball boob” look by choosing a gel implant (to minimize the risk of rippling) of appropriate size to give you a natural shape without too much projection or upper pole fullness.
Sub-muscular positioning would give a softening effect in the upper pole profile to a small extent but would probably not be worth the disadvantages involved with this choice (loss of muscle strength and possibility of breast movement with overlying muscle movement). There is no “one best way” to do breast augmentation. You and your doctor should discuss ALL options with their relative risks/advantages before finalizing your surgical plan. (Robert C. Bledsoe, Jr., MD, Dallas Plastic Surgeon)