Plastic Surgery and the Extreme Athlete

The upcoming Santa Barbara Triathlon this weekend has prompted me to blog on the topic of performing plastic surgery, specifically aesthetic plastic surgery, on athletes that push their bodies a lot further than most. This may seem like a group of people that really has no use for the services a plastic surgeon might provide, but that’s not entirely true. 


I have experience with treating many extreme athletes, and although most of them tend to be triathletes or distance runners and cyclists, I have also had patients who were body builders (men and women) and fitness models.   Women triathletes tend to be very lean and spend a lot of time outdoors. This seems pretty obvious, and it doesn’t take a big leap to understand that they tend to be very small breasted, if not downright flat-chested, and tend to get sun-damaged quicker than their less active contemporaries. So breast augmentation and facial rejuvenation procedures tend to be most common.


Breast augmentation in the extreme athlete is usually to provide a modest cup size, typically a B or small C cup, to restore some of the femininity that extreme training can take away. These athletes certainly don’t want to look “done”, as they still want to feel and look athletic and natural. There are always the questions of how it will impact training or competitiveness, but once healed, there is really no impact at all. Of course, during the healing process, there will be some unavoidable deconditioning as the athlete does have to take it easy and gradually work back into her previous rigorous training schedule. 


Facial rejuvenation often involves skin care and non-surgical interventions like photodynamic therapy to undo some of the effects of the sun. Injectables like the neuromodulators Botox and Dysport, and fillers Juvederm, Restylane, and Radiesse, may provide some volume in a lean face that tends to accentuate wrinkles.


Regarding men, the most common thing I see is a body builder that just cannot get rid of that little spare tire, no matter what. A little liposuction of the waist can be very helpful. And speaking of body builders, the other fairly common thing I see is gynecomastia (man-boobs), an occasional result of anabolic steroid use. This requires liposuction in addition to surgical removal of the fibrous breast tissue through a small incision hidden in the areola.


Douglas J. Mackenzie, M.D., F.A.C.S.

Pacific Plastic Surgery

Santa Barbara, CA

Douglas J. Mackenzie, MD

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