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 include the following: reaching across the chest, lateral (side-to-side) displacement of the breast and implant, the additional weight of the implant, increased drag, discomfort and possible muscle atrophy.

The ability to reach across the chest can be impacted. For someone with AA-cup sized breasts before surgery, the change is proportionally larger than for someone who begins 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 of the breast and implant can also interfere with the arm's range of motion. By keeping the implant diameter less than or equal to the diameter of the native 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 your body.

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. Conversely, if too much weight is added to the breast, similar symptoms can develop. 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.

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.

A rare complication of breast augmentation is chronic discomfort in the breast. Most discomfort is associated with the surgery itself. This usually resolves over a few days to weeks. Occasionally chronic pain develops. This is more common with larger implants, an