Would implants over the muscle be a mistake or possibiity for me? I run and lift weights.

Dear Anon453054,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You can elect to go over the muscle or under. The weight of the implant over time can lead to sagging. Under the muscle may help with this somewhat. Depending on the implants that interest you your surgeon may suggest using mesh to support your tissues and prevent bottoming out. Silicone does tend to feel more like natural breast tissue than saline, but that's just an opinion. Rippling and wrinkling can happen with any implant, but is more common with saline. The more breast tissue you have, the more these irregularities are disguised by your native tissue. I encourage you to discuss these concerns further with your surgeon.

If you have little breast tissue, I recommend placing the implants behind the muscle for better upper breast fullness and coverage.

Dear Anon453054,
Thank you for your questions. Weight lifting is one activity that putting the implant under the muscle might be considered a negative with the shape change in the breast associated with contraction of the pectoralis muscle, i.e. animation deformity. You can certainly put the implant subglandular, over the muscle, to avoid this. As you pointed out, you have minimal soft tissue to camouflage the implant, so it will be more readily apparent that you have an implant, particularly at larger volumes. Silicone is popular these days as it feels more natural and tends to ripple less than saline. I would encourage you to seek out a consultation with a board-certified plastic surgeon to examine you and develop a plan that is best tailored to meet your goals, with your tissue characteristics in mind.
Hope you find this helpful and wish you well.