I’ve been pretty open about my experience undergoing breast augmentation surgery as a technical diver and instructor.
Despite mostly positive and supportive responses to my oversharing, I’ve long felt that cosmetic procedures have an unwarranted stigma around them. As a result, it can be uncomfortable for some divers to bring this topic up to the dive pros in their lives and seek advice. Furthermore, some of the questions and comments I’ve gotten from fellow dive pros shed light on the fact that there’s a lot of misinformation out there perpetuated by lack of correction and discussion.
“How much extra weight do you need to descend?”
“You can’t dive to more than 40 meters… Your implants will explode from the pressure”
“Do you need to check your breasts for bubbles after a decompression dive?”
“Will your implants freeze if you go ice diving or get too cold?”
I can’t fault anyone for these ill-informed questions — I had the same ones when I started researching the procedure before deciding to go for it. The reality is, beyond a few hyperbaric studies conducted on various brands and types of implants over the years (which I’ll discuss later) and a DAN Q&A, there is very limited peer reviewed information out there on this subject, almost none of which discusses what divers may experience after undergoing this procedure.
I’ve written this article in an effort to help divers who are considering, or have recently undergone a breast augmentation procedure, as well as instructors who may be on the receiving end of questions about what this procedure means for divers. Here I’ll share all the things I wish I’d known before I went through with the procedure, what I’ve learned since about diving with breast implants, and some suggestions based on my experience.* It is my hope that this is useful information, or at the very least, an entertaining read.
*disclaimer: this is NOT medical advice and to always defer to your surgeon before doing ANY of this.
How will having breast implants affect me as a diver?
Pressure Changes and Decompression
Occasionally I see a post in one of the many Facebook groups asking whether or not breast implants will explode if you dive with them. It’s a fair question I suppose, and one that’s been the subject of several studies already.
A 1988 study looked at bubble formation in breast implants after simulated dives followed by altitude increases. Researchers recorded minimal bubble formation in the implants post-dive. Adding altitude to the mix, however, resulted in significant volume changes, but no implant ruptures. The authors of the study also noted that the circumstances that resulted in significant bubble formation and volume increase are “extremely unlikely to occur normally.”
In 2002, researchers put eight implants through a series of 40 simulated recreational dives to gain a better understanding of how they fare under pressure. No ruptures or volume changes were observed, though it’s worth emphasizing that this study did not subject implants to simulated decompression dives.
In 2004, a study similar to the 2002 one cited above involved subjecting implants from multiple manufacturers to a series of 68 simulated dives while monitoring for bubble formation and changes to shell integrity. While several implants in the study demonstrated “significant bubble formation” after 24 days of repetitive dives, the recorded changes were not significant enough to cause rupture.
TL;DR: breast implants are unlikely to explode or pop due to pressure experienced while diving. Diving with breast implants is a generally accepted as having minimal increased risk of bubble formation by both hyperbaric practitioners and plastic surgeons alike.
Buoyancy and Trim
Contrary to popular belief, breast implants will NOT make you more buoyant. In fact, they are often negatively buoyant, which may change your trim. The difference may be minimal, but if you already have somewhat floaty feet, the extra weight on your top half may exacerbate the situation. The size and type of implants you select will determine how much of a difference the implants make.
These days there’s several different types of implants available, but we can most broadly categorize them into two groups: saline or silicone.
Saline breast implants: Saline implants consist of an outer membrane made out of silicone which is inserted before being filled with a sterile saline solution and sealed. Saline implants are, you guessed it, neutrally buoyant in saltwater, which means they will not change your trim in saltwater. However, they will be ever so slightly negatively buoyant in freshwater.
Silicone breast implants:Silicone implants are extremely popular and widely available today. There are many different types of silicone breast implants out there — gel, cohesive gel (aka “gummy bear”), textured, etc. The important thing to understand is that all silicone implants are negatively buoyant in both salt and freshwater.
If you are considering implants but concerned about trim (as I was), you can technically “try before you buy” to feel just how significantly they may impact your trim. Ask your surgeon for the technical specs on the specific brand, model, and size of implants you’re considering. Figure out how negative they will be in freshwater and try placing the equivalent of that weight on your chest during your next dive. Fishing weights measured on a kitchen scale, placed inside an old stocking and stuffed into a sports bra work great for this. You could also consider explaining what you’re attempting to learn to your surgeon, and they may be able to help you out by lending a pair of “sample” implants to put into your bra.
I personally did not look too much into the trim implications for the size of implants I was considering — when I did the rough math, I realized that I could almost completely compensate for them by replacing my bungee fin straps with metal spring straps. Ultimately, worrying about my trim as I was wheeled into the operating room was worse than any actual changes to my trim — I hardly even noticed a difference post-op.
Let’s start with the obvious. You may need to invest in a new wetsuit, drysuit, and/or undergarments that can comfortably accommodate your new friends while also keeping you sufficiently warm. Even if you can kind of squeeze into your old suit, you don’t want to put too much unnecessary stress or pressure on your chest, particularly in the first year or so post-op while your body adjusts to the implants and they get settled into place. Depending on your frame and the size of implants you get, there is a chance that you will need to invest in custom exposure protection suits, which can cost a pretty penny and require some lead time to be made.
On to the not-so-obvious: you may want to get into the habit of packing some sort of boob warming apparatus in your post-dive kit, especially if you opt for large implants, undergo reconstructive surgery, or don’t have much natural breast tissue to begin with. The reason being, there is generally only a small layer of tissue and skin between your implants and the elements, which means they can lose heat quickly, especially in water. Unlike natural breast tissue, implants don’t have blood vessels running through them, which means it takes significantly longer for our bodies to warm them up. While you don’t need to worry about your implants freezing, the post dive cold can be very uncomfortable and at times painful, even after dives in balmy tropical water.
Fortunately, the fix is simple: come prepared with a few extra layers to put on and (only after getting your surgeon’s approval) pop a pair of hand warmer packs into your top once diving is over for the day or consider donning a heated vest. If you have access to one, a warm post dive shower can help as well.
Comfort and Support
As I mentioned above, you don’t want to put any unnecessary stress or pressure on your implants, which may require you to make some equipment adjustments.
From my experience, the most important equipment adjustment was support, so I gave all my cute string bikini tops away to a friend and started experimenting with more supportive options. My surgeon had advised wearing a surgical bra for several months after my procedure, and to date it’s still the most comfortable thing I’ve found in terms of support — but not a practical option for diving. Zip front sports bras have been a close second because they hold everything in place, but the best solution will be different for everyone. Experiment until you find something that is comfortable to you (and then tell me what it is because I’m still looking!) Also, word to the wise, underwire bras may be supportive but are NOT ideal for drysuit diving. Going without support is almost equally as uncomfortable.
After you’ve got your support sorted out, you’ll want to check in on how comfortable your BCD is.
If you’re diving a jacket style BCD, check the chest and shoulder straps. Does the chest strap land in an uncomfortable place or put pressure on the tops or sides of your breasts? Do the shoulder straps cut into your “side boob” region? How does the BCD feel with a tank and weights attached? Can you adjust things until you are comfortable? Some folks recommend switching to a “women’s BCD” specifically made to fit our curves while providing extra support via a built in bustier or similar. (Personally, I don’t like them and think the backplate/wing setup is better for this, but I’m sharing this so you know they exist.)
If you’re diving in a harness and wing (whether it’s backmount or sidemount), you may need to let it out a little bit (especially in your first few months back in the water) if it is cutting into the space between your breasts and armpits — this is another place where you do not want to add any extra pressure. Whether you adjust that part or not, I suggest checking the positioning of your chest D rings and adjusting before you get back into the water. Put your harness on and stand up straight with your arms lifted and extended straight from your sides. Make two thumbs up and close your eyes while bringing your thumbs to your chest. Where your thumbs hit your harness is where your D rings should be.
If you thought servicing your regulators on schedule was expensive, you’re in for a surprise here. Let me explain what I mean by maintenance.
While medical advancements have helped increase the average lifespan of breast implants significantly, they don’t last forever. On average, silicone breast implants last between 10 and 20 years before needing to be replaced. While multiple studies on implants and diving have found the two to be safe, the same studies have suggested “long term follow up” for divers undergoing the procedure due to concerns about repetitive dives impacting the longevity of these medical devices.
So, at some point I will need to go under the knife again to get mine swapped out or removed. That means I’ll be paying up for the equivalent of another boob job, taking on the risk of another surgery and round of anesthesia, committing to taking time off for recovery bedrest and worst of all, staying out of the water for several weeks at least. Honestly, these days I’d rather have a rebreather and a one-way-ticket somewhere sunny, but it’s a bit late for a change in heart. 😉
Advice for diving after breast implant surgery
To set expectations for how long you may be out of the water, most surgeons I spoke to said I could be back in the water within 8 weeks of surgery. To me this seemed really fast considering I was going to have the implants placed under the muscle (as opposed to over, which is generally considered the less invasive option). I was even more surprised when within 6 weeks of surgery, my surgeon told me I could go diving again. Ultimately, I can’t tell you how long you will be out of the water if you go through with a breast augmentation procedure. Only your surgeon can make that call based on your body’s recovery process.
Once your surgeon gives you the thumbs up AND you feel ready to dive again, what should you do?
My best advice for folks looking to get back into the water after breast augmentation surgery is this: take it slower than you think you need to. If you can get into a pool or similar shallow confined water with easy entry and exit points, do that before booking any big resort trips or charters.
Run through a skill circuit a few times to make sure you can comfortably execute each drill. You may be surprised by which movements suddenly feel uncomfortable or awkward. Valve drills, for example, might feel weird at first.
Consider asking an instructor to work with you for a day as you rebuild confidence. Keep things as simple as possible and move at your own pace as you adjust to this change and build your muscle memory back up. If a certain movement is painful, stop immediately and dive another day. Give your body time to heal.
The bottom line
So, there you have it. More than you ever could have wanted to know about scuba diving and breast implants for both entertainment and information. If I’ve left any questions unanswered, please feel free to reach out.
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