Breast Augmentation: Q&A

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Breast Augmentation for Body Builders - Above the Muscle?

I'm a competitive bodybuilder and powerlifter and I'm looking to have saline implants placed above the muscle. I'm currently a 34 A and would like to be a 34 full C- small D. Would saline be the right type of implant for my body type?

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A cup above muscle body builder

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21 Doctor Answers | Asked by Eva S in Seattle, WA

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Breast Augmentation for bodybuilders

I regularly perform breast augmentation surgery for patients who participate in body building, fitness and figure competitions. While many are initially concerned about sub-pectoral placement and the potential for distortion of the appearance of augmented breasts when the pec major contracts, I am absolutely confident that the aesthetic outcome for these patients will be far superior with implants placed under the muscle. A pre-pectoral implant in a slender patient, especially one with... more

Michael Law, MD

17 reviews

Raleigh-Durham Plastic Surgeon

michaellawmd.com

Tradeoffs in Breast Augmentation surgery

For very athletic women, as you are, I recommend implant placement above the muscle, but this results in less tissue for coverage of the implant, and with time, you may develop quite noticeable rippling of the implant beneath the skin and breast tissue. A better choice for your implant above the muscle would be silicone, which has a lesser tendency for visible rippling.

No easy answer for augmentation on athletic build

Unfortunately, this is a compromise operation. You will have to accept some of the disadvantages that are naturally a part of the operation and some of those are emphasized by the fact that bodybuilders in general have a very low percentage body fat which makes visibility of the implant much more likely. This is true whether the implant is placed under the muscle or over the muscle. One issue to consider is size. Going too large will not only give a more unnatural appearance it will... more

Ralph R. Garramone, MD

7 reviews

Fort Myers Plastic Surgeon

Saline implant on top of muscle?

Hello, As a very good rule of thumb, saline implants should be placed under the muscle, especially if there is very little breast tissue/low percentage body fat. Breast augmentation performed in the subfascial or subglandular plane (on top of the muscle) is ideally performed with a silicone implant and on patients with at least a 2cm pinch test thickness of the breast tissue. All the best, Dr Repta

Implants for Body Builders

If you are a true body builder, your implants should be placed above the muscle and not below the muscle. In these cases, since these patients have very little body fat I recommend silicone implants over saline implants because they will have less chance of rippling. However, I suggest discussing this option with your surgeon. I recommend a Smooth, round silicone gel implant, moderate profile using the base diameter as one of the major decision points for size and shape.

Rod J. Rohrich, MD

10 reviews

Dallas Plastic Surgeon

Breast Augmentation in Bodybuilders

Rachel, you have asked a very good question, to which there is no perfect answer. While there is always a trade-off in any surgery, the significant factors in body builders are 1) low body fat 2) desire to show good pec shape, size and definition. Because of these considerations, I usually recommend leaving the Pec alone, and accepting the tradeoffs of being above the muscle in a thin person. Specifically, these are visibility of the implants and visible rippling of the... more

Breast implants for bodybuilders - perfect solution?

This is a very tough question. There are pros and cons to having silicone and saline implants above and below the muscle. Traditionally, it is recommended to place implants above the muscle for people seriously pursuing bodybuilding carrier. The reason for that recommendation is that if the implants are placed underneath the muscle, high level of activity of pectoralis muscle will result in implant being squeezed out, or pushed out from its original position into “down and... more

You are likely to have rippling with Saline over the muscle

Hello, Athletic women seeking breast augmentation are challenging. Going "Over the Muscle" with saline implants might produce more problems. I would at least go "Under the Muscle" and might consider Silicone-filled implants to limit your problems.

Go with silicone, no reason to settle for less than the best

As you have realized, breast augmentation, like life, is full of trade offs. In someone like youreself who is a body builder and undoubtable has low body fat, there are real plus/minuses to where the implants are placed. With little breast tissue and body fat, usually I would recoommend going under the muscle. However, since you are a competative body builder, the distortion of the shape of the breast with contraction of your pectoralis major muscle speaks in favor of going on top or the... more

Above the muscle is your best choice

Rachel, You raise a good question. Since you are athletic, your best choice is to have the implant above the muscle. I think that silicone always looks and feels more natural than saline. Also, another option would be to have the implant placed under the muscle fascia, but above the muscles (sub-fascial placement). This placement allows an extra layer of tissue coverage around the implant, but avoids having to place the implant below the muscle. Not every plastic surgeon does... more

I would recommend a silicone implant

I think a silicone implant placed above the muscle would be your best option, and I would recommend a rather modest enhancement in size. The reason is that given your profession you probably have very little if any fat to hide the implant. In this case, the larger the implant, the more artificial the appearance. If you want the most natural look for your particular situation, I would discourage a major change in size (I would recommend a medium C as the maximum size goal in your case). more

Trade offs: Saline vs Silicone; Over or Under the muscle

In a competitive bodybuidler with realtively little body fat, the best implant for you would be a high profile cohesive silicone gel implant placed above the muscle. The disadvantages of this location are the potential visiblility. The advantage are the avoidance of distortion with muscular contraction. Any implant can have wrinkling or rippling. However, implants that have a higher profile tend to have less rippling and this may be the preferred shape for you. If the cohesive gel... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Yes, Ripped! No Ripples!

Competitive female body builders generally have very low body fat and small breasts to begin with. Breast Implant placement under this circumstance involves trade-off's in both the type of implant used, as well as the pocket location. Since the majority of the "ultimate" breast you will see will be composed of the implant rather than "native" breast tissue, the implant should be as close as possible to the "feel" of a natural breast. For this reason, I would... more

Beware the ripple

Rachel, The body building poster and autographed picture industry is replete with woman body builders and badly rippled saline filled implants. If you don't care for that look, you may be better off with silicone gel filled implants. They are less likely to ripple. Fortunately, you have that option since the FDA has reapproved the gel implants for augmentation in woman 22 years of age or older. Your choice of over the muscle is a good one for your profession for all of the reasons cited... more

Silicone is better for you than saline

A saline implant above the muscle is rarely as good looking as under the muscle. There are ripples and wrinkles especially in a person with minimal breast tissue and body fat. As you can see from the other answers you would be much better off with gel. I personally place them under the muscle even in very athletic people but you could choose to go above the muscle to eliminate any "active breast" deformity.

Silicone implants, above the muscle, would be your best choice.

A bodybuilder and competitor would not do well with saline implants above the muscle. Your goal as a body builder is to reduce overall fat while increasing muscle content. The thinner the breast tissue, the more important it is to place the implant behind the muscle, especially with saline. If you use silicone, it will help reduce the rippling effect. We wouldn't want you to have an abnormal pull or displacement of an implant when posing. This would not occur if the implant is above the... more

Silicone a better choice

For patients that are weightlifters and do not have al ot of breast tissue, the saline implants above the muscle may not appear as natural as silicone. More likely the saline will ripple. I would not recommend under the muscle becuase the muscle will cause animation deformities when it flexes.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Weight-lifter = silicone above the muscle (mostly)

Hi Rachel. I have seen a few weight-lifters after having breast augmentation with saline implants under the muscle, who are unhappy. The tightening of the pectoralis muscle (your "pecs") causes a noticeable squeezing of the saline implant such that a bulge is noticeable under the pectoralis muscle with each contraction. Most weight-lifters will benefit from having the implant placed above the muscle since it will not be interfered with during muscle contractions. The type of implant is... more

Body builders should only have silicone implants over the muscle.

I have seen your situation many times. You have to go over the muscle , as you say. Even the in-between approaches , such as dual plane (partially under the muscle) or sub-fascial will give you a deformity. The problem is that saline implants often don't look or feel good over the muscle. This is specially true in thin women, which body builders usually are. So I really recommend silicone implants (either moderate plus profile or high profile) for someone like you. Silicone implants have... more

Consider subfascial

Breast augmentation in body builders has been a special interest of mine, starting several years ago when a patient with submuscular implants consulted me for a deformity when she flexed her muscles. it is a really tricky trade-off, since women with low body fat need better coverage for the implants, but under the muscle is just not a good option for obvious reasons. Putting them over, on the other hand, often just looks too fake. A compromise is called subfascial, which provides better... more

You are a great candidate for silicone!

Dear Rachel, Without the benefit of an examination, I assume that as a body builder that your percent body fat is extremely low. As such, the movements of the implants, especially when posing during a competition are extremely important. Although both, saline and silicone implants have their place in breast enhancement, silicone implants look and feel better. Further, they move like natural breast tissue. Saline implants react like a water balloons. Oh! they are water balloons! I have... more