"I am getting into Cross Fitness and as I am researching I find where some say you should get your implants over the muscle and others say under. Then some say get small implants while others say size doesn’t matter. For pull ups, push ups, and things of that nature would you say unders or overs and what size? I am 4’11 and weigh 120 lbs. I’m 32/34 A/B deflated from breast feeding 5 kids. I want 450-500cc’s Saline unders for a DD/DDD. Should I get over or unders and what size for cross fitness?"


DR. POUSTI: Best Breast Implants if Planning Cross Fitness?

Thank you for the question.

There are pros and cons to the placement of breast implants and the “sub muscular” position versus the “sub glandular position”. There are also pros/cons associated with the use of saline implants versus silicone breast implants. I will try to outline some of the differences here; you may find the attached link helpful as well.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.

On the other hand, sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle) they can be seen with breast implants placed in these sub muscular position. Also, the immediate recovery period may be more comfortable after sub glandular breast augmentation as compared to sub muscular breast augmentation surgery.

In your case, I would probably suggest these sub muscular ( dual plane) presentation procedure understanding there will be a delay of many months before you can return to pull-ups, push-ups… Remember also that there probably will be some movement of the breast implants as your pectoralis contracts during exercise. Also, given that you probably will have very little adipose tissue/soft tissue coverage of the breast implants, you may want to consider the use of silicone gel breast implants.

In regards to the use of saline versus silicone breast implants, the type of implant used may Influence the final outcome of the procedure, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more “natural” result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture.

In regards to breast size, it will be important to communicate your goals carefully with your plastic surgeon. I prefer the use of goal pictures in this communication process. I find that this communication process is more precise than the use of cup size description (“DD/DDD”may mean different things to different people). Make sure that the size of breasts that you wish to achieve will not get in the way of the strenuous exercise program you are planning.

I hope this helps.

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