All about implants: The ‘why’, ‘who’, ‘what’ and ‘how’ of breast augmentation

While breast augmentation has become commonplace in modern society, the decision to surgically alter your body is not one you should take lightly.

Beyond the obvious considerations around cost – it is currently upwards of R60,000 – and the aesthetic benefits of your potential new look, anyone who is considering a boob job should also spend time working through the reasons why they want the operation.

Find your ‘why’

Biokineticist and online fitness coach, Sarah Lotter, who is also a WBFF and IFBB Bikini athlete who had the procedure done, always recommends to any client considering the op that they should do it for the right reasons.

If it’s purely for the aesthetic benefit then I generally suggest that they dig a little deeper. That’s because it is still a serious operation and your life will change after it. For those who heed my advice, I also suggest that they mull the decision over for a while before committing.”

Consider the ‘who’

Sarah adds that this advice also serves to give a person time to do the proper research to make an informed decision.

Find a reputable doctor who you can trust. This should be someone who cares about your health, first and foremost, and has enough professional integrity to advise you on the best surgical approach and, often more importantly, the most appropriate cup size and shape based on your body.”

Sarah adds that finding someone who has a good bedside manner is also important if you want to feel comfortable and at ease with your decision.

“My surgeon invested a substantial amount of time describing the procedure and laying out the risks so that I knew what it entailed.”

That was important for Sarah as it made her feel like he really had her best interested at heart.

“More importantly, from the outset he said he would do what he believes is best for me and my body, regardless of what I wanted.”

She believes that setting this expectation upfront is essential to avoid disappointment after the op or, worse, regret.

That all-important ‘what’

According to Cape Town-based plastic and reconstructive surgeon, Dr Willem Erasmus, settling on a size is a personal choice and no two girl friends want the same size.

“I always suggest going a fraction bigger than a client would like if they’re the conservative type, but always insist on selecting what a client’s figure can handle if they’re unconventional.

“For instance, women with narrow hips tend to look square if they go too big, while curvaceous figures can afford bigger implants.”

The two most popular types of breast implants are saline solution and silicone gel options. Sizes vary from very small (100ml) to very large (800ml), with a conservative option ranging between 160 to 250ml.

They also vary in projection. The choice lies between low, medium or high profile, depending on your anatomy, and how ‘perky’ you would like your breasts to be.

In terms of shape, implants can be either round or anatomically (teardrop) shaped. Round implants are more common because they provide optimal fullness, lift and cleavage. Low to medium profile implants can also provide a very natural teardrop look, which isn’t too round in the upper pole of the breast.

The anatomical shape was developed for women who prefer a more natural breast shape, but not all surgeons recommend them as they can rotate and cause the breast to distort, which requires corrective surgery. They also keep their teardrop shape, even when you’re lying down, which may look a bit odd.

Focus on the ‘how’

A major part of the pre-op discussions should focus on where the implants’ position. Dr. Willem says he likes placing implants under the muscle for most of his patients, particularly active women.

Sarah agrees with this approach, because in her opinion implants placed above the pec muscle generally accentuate the ‘fake’ look.

While there are those women who prefer this aesthetic, going under the muscle tends to look more natural, which is why I chose this option. I also wanted to ensure that I would still be able to breastfeed after I got the implants, which this approach offered.”

Recovery expectations

Another important part of the consultation process pertained to setting expectations around recovery time and the physical limitations an active person like Sarah could expect following the op.

Dr. Willem suggests that highly active patients such as Bikini competitors and serious athletes should carefully consider if they can cope with or accommodate a break from training of at least six weeks.

The first three days are when you swell the most. You can only do light exercises after four weeks and can generally get back to full training after six weeks,” he explains.

I also feel it’s important to mention that having good home support is more valuable than most people realise, because the week after can play with your emotions if you’re home alone.

In terms of pain, Sarah says her recovery was problem-free. “Moving around during the night proved to be the most painful, but taking the painkillers I was prescribed was enough to ensure I got sufficient sleep to aid the recovery process, which is vital. I also slept with a supportive bra for three months following the op.”

Be sensible, mindful

In terms of training, Sarah was off for a week before she started to do some light cardio. “After two weeks I started with light leg work, ensuring there wasn’t too much impact or exertion under load, and after six weeks I was back to light arm work. I followed the advice I give to my clients and what my doctor told me, which is to be sensible.

I didn’t rush it and if anything felt like it was pulling on my chest muscles, even slightly, I stopped immediately.”

In this regard, Sarah adds that you must be mindful of everyday activities, as reaching for something overhead or picking up a heavy item, or your child can cause or tear or rupture. But if you follow the guidelines and are cautious, most recoveries are hassle free.

Prep for success

The other aspect worth mentioning, which I feel helped my recovery, was that I was fit going into the op. I think this is important as it reduces your risk of complications and can accelerate the body’s natural healing process,” adds Sarah.

She also believes this is a sensible approach because it can help patients go into the op with their ideal physique.

Losing weight after you get the implants can change the entire aesthetic of the body, and there is also a risk that the implants will drop. I therefore always recommend that my clients achieve their goal weight before going for the procedure. The breast augmentation is then there to complete your look and make you more aesthetically pleasing, whether it’s for the competitive stage or the beach.”

A final word

As a final consideration, Sarah suggests that highly active individuals such as elite athletes or competitive CrossFitters consider waiting until their sporting careers are over before getting a boob job.

You spend a lot of money on the procedure, which should last 10 or more years. But the implants will deteriorate at a quicker rate based on the volume and intensity of your activities. You also need to consider the risks of rupturing during intense or high-impact sports, so choose the right time in your career to do it if you want them to last.”

Author: Pedro van Gaalen

When he’s not writing about sport or health and fitness, Pedro is probably out training for his next marathon or ultra-marathon. He’s worked as a fitness professional and as a marketing and comms expert. He now combines his passions in his role as managing editor at Fitness magazine.

When he's not writing about sport or health and fitness, Pedro is probably out training for his next marathon or ultra-marathon. He's worked as a fitness professional and as a marketing and comms expert. He now combines his passions in his role as managing editor at Fitness magazine.

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