Breast Augmentation: Q&A

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Under Muscle Breast Augmentation for Tight Pectorals?

I'd like to enhance my breasts and am looking at the options. I am a fitness competitor and trainer and I worry about the effects of under the muscle implant placement. I have a tendency toward very tight pectorals which has resulted in some issues with my training. I am a full B cup (small C depending on the bra). I would like to go up, maybe a little more than one cup, but less than two. My sister recently got implants and her doctor does not even offer over the muscle procedure. Is this a standard in Breast Augmentation now? It seems like everything I read leans toward under the muscle. Would "unders" be an option for me with my training concerns and chronically tight pectorals?

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18 Doctor Answers | Asked by Melinda75 in MA

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Breast Augmentation in a Fitness Competitor or Trainer

In general, most of the time I use saline or silicone gel implants below the muscle because they have a tendency to look and feel better and mammograms are easier to perform. However, in patients who are fitness competitors and trainers, I use a subglandular breast augmentation with a silicone gel implant because of the fact that most of these patients are lean, have minimal amount of breast tissue, and don’t want their implants to move during these fitness competitions. more

Rod J. Rohrich, MD

10 reviews

Dallas Plastic Surgeon

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

Consider subfascial implant placement

Your situation is actually common but one that requires special consideration. Traditionally, under the muscle is recommended for better coverage of the implant and more natural contours. However, athletes such as yourself are usually advised to have them over the muscle, because of the tightness of the muscle and the potential for what are called animation deformities (which is distortion of the breast with physical activity). But going over may mean that coverage isn't good because of low... more

Under the muscle vs over the muscle breast augmentation

Hello, A breast implant can be placed under the muscle, on top of the muscle under the cover of he muscle (subfascial), or over the muscle under the breast gland. In general, saline implants should be placed under the muscle. Some patients with very thick breast tissue may be ok with saline on top of the muscle but in general saline implants should be placed under the muscle. Silicone implants can be placed under or over the muscle. Very thin patients and patients... more

VIDEO: Dynamic animation deformity with well defined pectoralis

Individuals with well developed pectoralis muscles tend to prefer over the muscle placement which can make the implants more visible. If placed under it is more likely to result in the dynamic animation deformity: see attached video see video

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Implants in trainers

Tight or not the implants can go under the pectoralis msucles. These are usually cut to accomodate the implants along the inferomedial aspect. But, they might move funny especially in a weight trainer. You may want to consider above the msucle if you have enought soft tissue to cover them.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

There are trade-offs in implant techniques

In general, body builders and fitness trainers opt for implants over the muscle (subgalndular). When you contract the muscle a lot, it distorts the implants. Placing the implants under the muscle also requires cutting and dissecting muscle that may alter your normal anatomy when you pose. If you have a significant amount of normal breast tissue (large B/ small C) then you may be able to effectively hide your implants behind your breast tissue making for a very natural result without the... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Submuscular implants are usually better

The placement of an implant partially submuscular (under the pec major) has the benefit of better mammograms than above the muscle, less edginess of the implant, less implant palpability, less capsular contracture, and a more natural long term look. Depending on how your surgeon handles the muscle, there can be more or less of an "active breast" deformity under the muscle. This is the main trade-off but usually is outweighed by the above benefits even in body builders and fitness experts.... more

You can have the implants above the muscle

RedGirl122, It is okay to have your implants above the muscle. If they are put under the muscle, the muscle needs to be cut in order to accommodate the implant. However, if you are an athlete, then you may prefer to the have the implant placed above the muscle. Just find a plastic surgeon who is comfortable doing this procedure. Good luck.

Both implant placement are options

The reason most Plastic Surgeons recommend sub-pectoral (beneath the muscle) placement of the implants is: 1 - Long term, there is less incidence of capsular contracture 2 - Better for mammograms 3- More natural slope to the upper pole of the breast, especially long term 4- Less chance of feeling the implant. The main disadvantage for a fitness competitor is when the pectorals are flexing, it can distort the breasts. I have implanted a number of body builders both above and beneath the... more