Regarding subpectoral breast augmentation, what are the considerations for weight lifters?

I'm more of a powerlifter than a bodybuilder (though still fairly lean), and have a dedicated chest day at least once a week. Other than the prescribed time off following surgery, are there any additional considerations that I should make? Ex: should I stop working chest prior to surgery, and will my chest pectoral muscles still develop and gain strength similar to how they would have prior to the procedure? Thank you for any answers you can provide!

Doctor Answers 16

Breast augmentation in a power lifter.

Great question and  one asked frequently. I can tell you within my own practice I  have many competitive body and fitness patients as well as triathletes  and runners. I workout with a women whose implants I placed sub pectoral and I can attest that she demonstrates a very natural and functional appearance.  It is a safer location and provides a much more  natural outcome. No need to slow down the workouts before surgery and resuming the routine can  be initiated with gradual progression about 4-6 weeks postoperatively. Strength and range of motion can be perfectly preserved as well as prevention of animation deformity if the surgery is done safely preserving most of the pectoral origins along the central breast bone. Best of good luck. 

Baltimore Plastic Surgeon
4.7 out of 5 stars 74 reviews

Where to put implants for body builders

Thank you for asking about your breast augmentation.

  • This is an important question not just for body and power builders but for any woman who does sports that develop strong pectoral muscles.
  • First, the muscle can flatten the implant when you tense the muscle. This looks odd in snug tops.
  • Second, the muscle activity over time can shift the implant out of position.
  • Third, an implant separates the muscle from the ribs. It can alter the strength or direction of pull of the muscle and the muscle may lose its normal definition.
  • This doesn't mean a power builder shouldn't have implants under the muscle -
  • There are pros and cons to implant over and under the muscle.
  • It does mean that you should discuss what's important to you  with your surgeon in advance to be sure you choose the right implant position - for you. 
Always see a Board Certified Plastic Surgeon
Hope you found this answer helpful. Best wishes

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Regarding subpectoral breast augmentation, what are the considerations for weight lifters

Research shows that you will lose about 5% or so of your pectoral strength. The submuscular placement will also allow the implant to fold while flexed. It can also lead to the implant being pushed down and out over time due to the forces generated by your pectoral muscles wanting to lay flat on your rib cage. No need to stop doing your bench pressing but it will be 4-6 weeks before you can go back without restrictions.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Regarding subpectoral breast augmentation, what are the considerations for weight lifters?

Very good question.  In my practice I place all of my implants sub-muscularly.  There are many good reasons to do this: better cancer surveillance, less risk of developing a capsular contracture and better long term results.  I have many women in my practice that are body builders, swim suit models, runners and triathletes.  On occasion they can develop an animation deformity but it is not common even in the sub-muscular plane.  I do recommend that they do more toning and strengthening exercises with their pectoralis muscles rather than heavy lifting after the procedure to decrease their risk.   As to your last question, your pectoralis muscles will develop and gain strength normally after the healing process has ended.  I hope this helps.

Jeffrey Antimarino, MD, FACS
Pittsburgh Plastic Surgeon
5.0 out of 5 stars 55 reviews

Regarding subpectoral breast augmentation, what are the considerations for weight lifters?

There are two issues with weight lifters: animation deformity and implant malposition. The deformity comes when the pectorals is contracting which can cause the implant to temporarily change shape while working out. Implant malpostion can happen over time with repeated contractions from a strong pectorals. this can increase the volume of the pocket causing the implant to rest in a more lateral position even at rest. There are several advantages going behind the muscle, but these must be taken into consederation with the risks as stated above. The implants can always be placed in front of the muscle. There are some newer silicone gel implants with less risk of wrinkling and rippling that may be a suitable option in this situation. Best of luck!

Keith Hodge, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 27 reviews

Regarding subpectoral breast augmentation, what are the considerations for weight lifters?

Thank you for your excellent questions.  The greatest concerns for heavy weight lifters and breast augmentation center on animation deformity and implant malposition.  Animation deformity occurs once a woman fires her pectoralis major, shortening the muscle fibers, and applying pressure to the underlying implant.  It can cause the implant to move in a down and out direction.  Once the contraction stops, the implant returns to its previous position, but the movement can be both aesthetically unappealing, and physically irritating to some.  Secondly, repeated heavy chest exercises can stretch the breast implant pocket, allowing the implant to move in undesirable locations with standing or laying down.  Because of these concerns many serious lifters have implants placed above the muscle to minimize these complications from exercise.  Regardless of implant position, your chest muscles can continue to develop and gain strength after the procedure once you are fully healed.  Hope that this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

You may lose some power...

Depending on how large your chosen implants are and your tissue characteristics, you will need to consider the tradeofs of each option.

Placement under the muscle will provide more coverage. Don't choose this option if the idea of animation deformity is unacceptable to you. This simply means distortion of your chest when you flex your pecs. This might be problematic if you plan to do photo-ops/pageants like some professional bodybuilder a do. If you have thin tissues you may still be able to feel the lower half of the implant as there is usually no muscle coverage in this area. There is usually no significant drop-off in pectoralis major strength once a woman's breasts are fully healed from surgery. Having said that, it is possible for a professional body builder to notice a long-term difference. This is more likely with larger devices.

The other alternative is implant placement in the subglandular position.  This has no impact on muscle function whatsoever.  The risk of capsular contracture is higher however.  This risk can be decreased by choosing certain types of implants over others.

Chuma Chike-Obi, MD
Austin Plastic Surgeon
5.0 out of 5 stars 11 reviews

Subpectoral breast augmentation for weight lifters

For any patients with extremely developed pectoral muscles:

1. You can continue to work the chest before surgery, but make sure to take the recommended time off after surgery.

2. Sub-pectoral implant placement means the lower part of the pectoral muscle is opened to place the implant in a pocket under the muscle.

After surgery the pectoral muscles will still develop and gain strength, but different factors (anatomy, type of implant approach, size of implant) may change future pectoral development, at least in the short term.

3. Your surgeon should have extensive experience with muscular patients so that issues specific to pectoral muscles (such as appearance during flexing) can be minimized.

As always, make sure you communicate with your surgeon well and good luck!

Samuel Rhee, MD
Clifton Plastic Surgeon
5.0 out of 5 stars 18 reviews

Here Are Some Things to Consider

Those are excellent questions. With bodybuilders, there are 2 issues with subpectoral implants. The first is an "animation deformity," which occurs when the pectoralis muscle contracts. It usually pulls the implants upward and outward. This can look disfiguring during a workout or in competition. The other issue is that over time the contraction of the muscle can cause the pocket to distort and lead to a malposition of the implant. Your muscles will regain strength after the surgery if implants are placed in a submuscular position. If the animation deformity and the possibility of malposition over time are potentially significant issues for you, then the implants should be placed in a subglandular pocket. There may be more rippling with the implants in this position. So, the "take home" message is that there are compromises with each technique. Thanks for your questions.

Louis C. Cutolo, Jr., MD, FACS
New York Plastic Surgeon
4.6 out of 5 stars 13 reviews

Breast Augmentation for Weight Lifters

I generally prefer to place implants over the muscle, particularly in weight lifters. This avoids the animation deformity that is automatically associated with a sub pectoral implant. Additionally, strong muscles tend to push the implants upward and malposition is common. Have this discussion with your plastic surgeon. If he or she is not comfortable offering sub glandular implants as an alternative, I would suggest further opinions.

Marshall T. Partington, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.