Breast Augmentation for Body Builders - Above the Muscle?

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 increase the chance of implant visibility meaning a greater chance of visible rippling and wrinkling. A more conservative size implant will look more natural and that will have less of the chance of visible rippling and wrinkling. A more conservative size implant will also keep you looking in proportion and more athletic. With regard to this issue the silicone implant is preferable because in general it not only feels more natural but it looks more natural because there is less of the chance of rippling and wrinkling compared to saline implants.

The next issue to consider is whether to put the implants under the muscle or over the muscle. There are disadvantages to each of these choices in bodybuilders. Over the muscle or more accurately, sub glandular, results in less soft tissue coverage which could increase the chance of being able to see the implant. This means that rippling will be more visible.

Unfortunately, placing the implant under the muscle increases the chance of movement of the implant with contraction of the pectoralis muscle, which in many cases is undesirable. It can be difficult to predict how much movement of the implant will be present, but in all likelihood, there will be some. So you need to choose which of those problems you want to try to avoid, and which of those problems will be acceptable to you if they are present after the surgery.

I would recommend silicone gel implants and leave up to you whether he would prefer over the muscle, sub glandular or under the muscle, sub muscular given the issues noted above.

Thank you for your question.  Your situation represents one of the strongest indications for a subglandular (above the muscle) breast augmentation.  This will avoid issues of animation (moving) of the implants upon flexing of the pectoralis, as well as distortion of the contour of the pec by the implant itself.  Either saline or silicone implants would be a reasonable choice.  My personal preference as a surgeon is toward silicone implants, which produce a bit more of a softer, more natural feel, and have been proven safe and reliable.

Hello! Thank you for your question! Breast augmentation is a procedure often sought by women to increase size, add upper pole fullness and projection along with improve shape and symmetry of her breasts. Women who have the breast augmentation done report increased self-confidence, self-esteem, and more comfortable with her body. In fact, it has been the most popular procedure in plastic surgery in the US for the past few years. In general, implant size does not correlate with cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size or implant size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. Your breast width is the most important measurement. Given your description, i would consider above the muscle and consider a shaped, silicone implant.Things to to consider during your consultation, which your surgeon will discuss with you, include implant type (saline vs silicone), shape/texturing of implant (round vs shaped/textured vs non-textured), implant position (sub pectoral, subglandular, or subfascial), incision (inframammary fold, periareolar, axillary, or TUBA), and size of implant. This can be performed with/out a breast lift, which would serve to obtain symmetry in breast size or nipple position as well as improve shape. Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory. I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width. Too large of implants for the woman often destroys the breast pocket and breast shape, thus creating an oft seen uncorrectable problem later. Very slightly less tissue may be visualized with subglandular implants, but not very significant.Implants may be placed either in the subpectoral (beneath muscle) or subglandular/subfascial (above muscle). Both locations are excellent and you can choose either one - your surgeon will discuss the pros and cons of each. In general, while a placement above the muscle is a more natural position for an implant to augment the actual breast, I find that it is not desirable for very petite women or women with a paucity of breast tissue - as the visibility and potential rippling seen/thinning of tissue may give a suboptimal outcome. A subpectoral pocket adds additional coverage of the implant, but causes slightly more and longer postoperative pain/swelling as well as the potential for animation deformity with flexing of the muscles. Today, there is no virtually no difference in rupture rate, capsular contracture rate (slightly higher with subglandular as well as certain incisions), and infection with the positions. As you see, there are a few factors to decide upon for incision, placement, and implant type/size. Consult with a plastic surgeon who should go over each of the options as well as the risks/benefits. Hope that this helps! Best wishes for a wonderful result!