Breast Implant Muscle Distortion

I am considering saline unders, only about 125 c. I am worried about muscle distortion as I work out strenuosly 8-9 hours a week in kickboxing and self defense classes where we work in partners. How noticable is it normaly, and does it worsen with larger implants vs. smaller?

Doctor Answers 12

Breast Enhancement Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I think its overrated, if you work out a ton and are using small implants go above the muscle it will be fine

Muscle Distortion of Breast Implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Placement of your  breast implants underneath the chest wall muscles does cause some distortion when the muscle is contracted however at rest, they will appear fine. Placing the implants on top of the muscle avoids this problem but at an increased risk of breast hardness. I do not know your height and weight nor have you provided pictures but 125 cc implants will hardly be noticeable and I seriously question using such a small implant.

Richard Linderman, MD
Indianapolis Plastic Surgeon

Implants under the muscle

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I prefer in most patients to place implants under the muscle.  It is difficult to predict who will have this motion issue.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

"Dancing breasts" implants that move with muscle contraction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is an unusually small implant when it comes to the typical breast augmentation. In most activlites you do not use pectoralis contraction and an "animation deformity is not likely to occur. However, the alternatives to a small implant include breast augmentation with fat grafting. This is less likely to result in distortion with contraction.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Muscular distortion not often a problem

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi there-

While, mechanically speaking, contraction of your pectoralis muscles will necessarily cause alteration of your breast shape, this is generally not a problem for even very active patients (as long as you don't exercise nude).

I also agree that silicone implants will give you a better outcome with less risk for rippling and an unnatural appearance.

Distortion with implants under the pectoralis muscle

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

As you can see from the answers there is no uniform answer or approach to this issue. There are always advantages and disadvantages and tradeoffs. 

I disagree with the statements about the size of the implant. If the implant is properly sized and positioned, it's size in cc's has nothing to do with the animation issue. The issue can be avoided by implants placed above the pectoralis muscle but they almost have to be silicone gel without the muscle for padding and there are short term and long term drawbacks to this approach. 

I find that the degree of animation distortion with the implant behind the pectoralis muscle is variable and unpredictable regardless of the size or type of the implant but seems more common in somewhat sagging (ptotic) breasts or when the inframammary crease needs to be lowered. Most women including very active or bodybuilding types don't have much problem with this but the group of show-bodybuilders who are showing off their chest with next to nothing on and flexing their pectoralis maximally do find the animation a problem. 

The best solution while keeping the implant behind the pectoralis in the upper part of the breast is the split or dual-plane release to get the free inferior/lateral border of the pectoralis up and out of the lower pole of the breast so it can't pull and distort it while still functioning in the upper pole of the breast. This is also the corrective procedure for double-bubble deformities which is at least partly caused by distortion along the lower edge of the pectoralis muscle. 

I'd still recommend below the pectoralis muscle positioning of an implant that fits where it belongs but done by a plastic surgeon who knows how to release the pectoralis muscle out of the lower pole of the breast. This is also best done via an inframammary crease incision (only 2 cm for saline) which is also best long term. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Subglandular breast implants best in very athletic women.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


1) Definitely, small implants are best for you.

2) For someone like you, muscle distortion can be very noticeable. So I would only put them over the muscle. What makes you think that is a bad option?

3) I would also recommend silicone implants. They are safe and avoid rippling.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Breast Implant Muscle Distortion

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes you should be concerned if you do so much "working out"1 As the size increase so does the distortion as you correctly understood. Best to think about above placement. 


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Put them over the muscle and you will have no distortion problems ( unless you get capsules which can happen no matter how they are done).

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

They important issues here are your body type, current breast size and anatomical characteristics as well as the activities you describe. WIthout knowing all of these factors a plastic surgeon cannot make any specific recommendations to you. For a lean individual who wants only a slight increase in breast size 125cc saline under the muscle is a valid option. Large implants under the muscle certainly have a higher risk of distortion with muscle animation. How large depends on the individuals skeletal frame size. I would be more concerned if in partner practice or sparring you sustain direct blows to the chest a breast implant can rupture even if you have an underfilled saline implant. If that is the case saline under the muscle is probably your best bet.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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.