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Exercise and Breast Implants

Exercise and Breast Implants

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I am often asked if breast augmentation limits athletic ability. Does the placement of implants somehow weaken an athlete? Will their weight cause instability? Does placement under the pectoralis major muscle cause loss of muscle function? Like many questions in medicine, the answer depends on the specific variable for each individual.

Size matters, and the larger the implant the greater the potential impact. Variables influenced by the size of the implant include the following: reaching across the chest, lateral displacement of the breast and implant, the additional weight of the implant, increased drag while swimming, discomfort, and possible muscle atrophy.

Reach

For someone with AA-cup sized breasts before surgery, the change is proportionally larger than for someone with B-cup breasts. The implants may be more noticeable with sports that require extreme inward rotation at the shoulder with the arm extended. Examples include golf and racket sports like tennis and racket ball. Unless the implants are quite large, most athletes adapt quickly and can compensate by increasing rotation of the torso at the waist.

Lateral displacement

Lateral Displacement of the breast and implant can interfere with the arm's range of motion. By keeping the implant diameter less than or equal to the diameter of the natural breast, the feeling that "they're in the way" can be minimized. This is also a good way to keep the result proportional to the rest of the body.

Weight

The weight of the implant is another factor. Women with large breasts (especially those desiring breast reduction surgery) often complain of lower neck, upper back, and shoulder pain. Removing breast tissue - usually several pounds, relieves these symptoms. Similar symptoms can develop if too much weight is added to the breast through an augmentation procedure. However, since most implants weigh about three quarters of a pound, this problem is rare. Exercise routines that include running and jumping may make the weight more noticeable, but with the proper support, these activities are usually well tolerated.

Swimming 'drag'

Competitive swimmers may notice slightly increased drag, but for the recreational athlete little change is noted. Since most implants used for augmentation are filled with saline (salt water), they are essentially neutrally buoyant. In other words, implants won't make you float on your back or sink to the bottom of the pool.

Discomfort

A rare but possible complication of breast augmentation is chronic discomfort in the breast. Most of this discomfort is associated with the surgery itself. It usually subsides over a period of a few days to a few weeks. Occasionally chronic pain develops. This is more common with larger implants, and may be related to stretching the capsule around the implant. Massage to compress the implant, displacement exercises, adequate support, and medication usually help, but this may require some time away from strenuous activity. Again, this is not a common problem, but in a few cases the implants have to be removed or reduced in size to provide relief.

Possible muscular side effects

There are no large clinical trials measuring upper extremity strength before and after breast augmentation, but anecdotal evidence suggests that weakness in the muscle is usually temporary, and is related more to the discomfort of surgery than to the implants.

Most bodybuilders elect to have implants placed in front of the pectoral muscle because of interference with muscle function. During certain poses, their implants--if placed behind the muscle--would raise up. Although the implant is more obvious in front of the muscle, as the cover of many muscle magazines will attest, there is less movement with posing. Nonetheless, there is anecdotal evidence that implants of reasonable size can be placed under the pectoral muscle without interfering with function, and many of my patients continue to enjoy exercising and weight lifting after their surgery without significant changes in their routine.

As with anything in life, oversized breast implants can prove to be too much of a good thing. Keeping the changes proportional to the rest of your body will help to minimize any interference implants may have on your physical activities. Whether you're looking to increase your breast size or restore lost volume due to weight reduction or pregnancy, breast augmentation can be a satisfying alternative, with minimal interference with your lifestyle.

Find a good surgeon

In order to minimize the risks mentioned above it is important to choose a well-trained and experienced surgeon. It is also a good idea to seek out a qualified Board Certified Plastic Surgeon, who is comfortable with the procedure. Ask to see representative before and after pictures of the surgeon's patients. Also ask about his or her experience with patients' level of physical activity after the procedure, and when you can expect to be "back to normal." If you personally do not know anyone who has had the surgery, many plastic surgeons can provide you with the names of patients who are comfortable talking about their experiences. Even though breast augmentation is an outpatient procedure, your surgeon should have admitting privileges at a local hospital for the rare circumstance where you might need to be admitted.

Dr. Joseph A. Mele, III, M.D., F.A.C.S. is chairman of the Division of Plastic Surgery at John Muir Medical Center located in Walnut Creek, CA. He is certified by both the American Board of Plastic Surgery and the American Board of Surgery and is an active member of the American Society of Plastic Surgery.

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