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The Cold, Not-So-Hard Truth about Exercising With Breast Implants

As we soldier through winter days and frigid temperatures, those of us with breast implants know only too well that keeping toasty is no small task. And, if you participate in sports or exercise throughout the season, the challenge can be even greater. The solution is not as simple as just adding layer upon layer, as this can be very constricting and, further, cause the rest of your body to overheat.

Ever since I had prophylactic mastectomies and immediate breast reconstruction surgery with implants several years ago, I shiver all winter long. My standard indoor attire consists of multiple layers—a tank top, long-sleeved tee, and cozy sweater-knit hoodie. When I go outside in any temperature under 40 degrees, I wear a fleece vest over a down-filled jacket. If you share this experience, know that you’re not alone. In 2012, about 50,000 women had breast reconstruction with implants after mastectomy. That’s a lot of women shivering throughout the winter, which is good news for fleece sales, but bad news for those of us who want wear a skimpy dress on New Year’s Eve.

I started hearing complaints about this from fellow breast reconstruction patients when I began working for the plastic surgeons that pioneered the direct-to-implant technique. I have received many emails about this issue, with complaints such as: “I start shivering when I drink anything cold,” or, “I have to shower immediately after working out or my teeth start to chatter.” One woman wrote that she could never have ice in a beverage because it would make her shiver for hours.

Here’s the reason why we get so cold: Many women have little sensation in their skin after breast reconstruction because nerve endings were severed during the removal of breast tissue. That sensation rarely comes back except on the periphery. Frankly, many of us would actually worry if we had sensation there, because it might mean that some (cancerous) breast tissue was left behind. We can feel the cold of the implant because of the nerve endings on our chest wall, but our skin has little or no heat or cold sensation. After mastectomy (or even augmentation for very thin women), there is so little fat under the skin that the implant basically sits directly under the skin and on top of the chest wall, with nothing “insulating” it. When it gets cold, so do you.

So, when it comes to exercise, we have to get imaginative. When I go running in the winter months, I look like the Michelin man! One of my patients (and fellow runners) contacted me to share ideas about how she gears up for cold weather workouts. She told me that if she bundles up too much for a run, her chest area is comfortable but her back begins to sweat early on. She found some success with the following ensemble:

• Sports bra with pads in the pockets
• Tight racer back tank
• Thin, long sleeve base layer
• Lightweight cycling jacket with removable sleeves
• Hat and gloves

She said that instead of unzipping the front of the jacket when she gets warm, she removes the hat, gloves and jacket sleeves and then pushes up the sleeves of the base layer. Then, when cooling down, she puts the pieces back on in reverse order (noting that they all fit in the pocket of her vest). After the workout, she immediately changes into dry clothes from the waist up. She said that when she uses this system, after the run her breasts are much warmer to the touch that they would have normally been.

If you have ideas to share or a special way that you gear up to be out in the cold, we’d love to hear them!

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