With the latest FDA s approval to allow the use of silicone gel breast implants, there is already an increased interest in having safe breast augmentation surgery. I ve built up my body but lost my breasts is a statement heard by many a plastic surgeon from their physically active patients. Since fat supplies some of the volume of the breasts, as your body fat percentage decreases, so does the size and fullness of your breasts. Too many women feel that in order to be fit they have to compromise their femininity. However, silicone to the rescue! Breast implant surgery can be the answer to this problem but there are several questions

that come to mind in regard to these implants, especially pertaining to training females who have had the surgery.

Let s examine these questions one by one.

How fragile are the implants with regard to training?

The silicone implant has many advantages over saline in training the athletic female. It both looks and feels more natural, especially when there is a thin amount of tissue covering the implant; as is the case with a female with a low body fat percentage. Silicone implants are also more durable that the saline filled implants. The saline implant consists of a thin shell of solid silicone material filled with saline. Saline, a salt water solution, doesn t have the

same viscosity or thickness. As a result, the saline in the implant will be affected by both gravity and muscle contraction as they exercise. The saline easily flows into a portion of the implant causing a slight collapse or rippling of the shell of the implant. These ripples create areas of weakness in the outer cover of the implant. Since a silicone implant doesn t collapse, this is not a problem. Saline implants are prone to deflation even without the stress of exercise and should be routinely replaced every ten years. On the other hand, silicone implants may have to be replaced only once during the life of the implant.

How are these new

implants different than the ones that previously caused concern?

The major concern with the previous silicone implants was possible leakage of the inner silicone gel if the outer shell of the implant was compromised. It was this leakage and spread of this gel that was considered the cause of the hardening, excessive internal scarring and possible more serious conditions.

The new implants are called cohesive gel or gummy bear implants. The new implants are designed with a gel that stays together even if the outer shell of the implant is damaged. As such, there isn t the same reaction of the body, preventing the complications and avoiding the concerns of vigorous training the previous

silicone implants.

Is it better to have the implants above or below the muscle?

While surgeons not familiar with exercise advise placing the implants above the muscle with a physically active female, it has always been my opinion, as well as that of other surgeons who operate on athletic women, to place the implant partially beneath the pectoralis muscle. As stated above, athletic women have a low body fat. If the implant is placed above the muscle, this thin covering will give a very unnatural look. You see the entire outline of the implant giving a glued on appearance. By placing the implant partially beneath the chest muscle, it creates a much more pleasing and natural

appearance. Even strong women have pectoral muscle that will allow insertion of the implant and conform to it s contours.

In addition, the implant acts as an insulator to heat. Woman with the implant between the skin and the muscle tend to always feel that their breasts are cold. If the implant is beneath the muscle, the circulation in the muscle keeps the skin of the breast warm.

One of the most common complications of breast implant surgery is called capsule formation or a firming of the breast. This occurs if the pocket around the implant starts to condense and squeeze or compress the implant. This occurs frequently in implants placed above the

muscle. When the implant is sub-muscular, the action of the muscle during training massages the implant and tends to keep it soft.
While it is often been considered a problem when the implants are seen to shift during chest exercises, the reverse is actually the case. The breasts remain soft if the pocket containing the implant doesn t narrow and contract around it. It is this movement of the implants during exercise that keeps the pocket expanded and the breast soft. The downside of going below the muscle is some initial increased pain and discomfort.

How soon after the surgery can exercise begin?

Low impact cardio can even start 1-2 weeks following the procedure. I

wait to start resistance training until six to eight weeks passes. By this time, the implants should not shift and light chest exercises as well as other resistance training can begin. I start my clients with a super-slow routine to avoid early ballistic movement and allow the client to get the feel of the muscles in contact with the implant. The best rule of thumb is to progress slowly as things begin to feel more and more comfortable. After twelve weeks, there are no unusual restrictions.

Will I lose strength with implants under the muscle?

Even under the muscle, this does not pose a problem. While there may be an initial adjustment of the muscles to

the implants, strength returns to normal quickly. Several studies report return of bench press strength within 12 weeks after the surgery. After this gains are the same as if you never had the surgery.

Now that safer implants are available, athletic women can again benefit from breast implant surgery. However your client should consult with a surgeon experienced in operating on athletic women. The surgery is a bit different when dealing with strong pectoral muscles. http://www.niptuckfitness.com

Bruce J. Nadler M.D. is the ultimate specialist in body shaping. He is both a retired cosmetic plastic surgeon and certified personal fitness trainer (ACSM), now living in Los Angeles. With 28 years of experience in surgery and

personal training, he founded Nip Tuck Fitness LA. He is the author of “The Nip Tuck Workout, Exercise through the Eyes of a Plastic Surgeon” and the originator of the “Plastic Synergy” exercise system. This system is based on the plastic surgical principles of proportion and symmetry, giving plastic surgical-like results with exercise. His clients include many notable celebrities in the music and fashion industry.