I’m a circus flyer (aerial silks) and I’m looking to get breast implants, would you suggest under or over the muscle?

It's a great question, but I still feel like the advantages of placing the implant in the submuscular position out weight any disadvantages, even in your situation.  Ultimately, putting the implant under the muscle gives the best long-term result and lowest amount of complications, even in patients with a lot of upper body (pec muscle) strength.  Just choose a board-certified plastic surgeon with a lot of experience in this surgery, and you'll do great.  Good luck!

Thank you for sharing your question!  For most patients the best placement remains submuscularly to achieve a more natural look, fee, and minimization of risks.  Hope this helps.

As a bodybuilder, I augment professional athletes frequently.  I think for those people in whom the living is made by athletic performance, the implant can be placed above the muscle.  Other patients will be happier longterm with submuscular placement. Consult with a board certified plastic surgeon who performs hundreds of breast procedures annually to determine the correct size for your build.

Thank you for your question.  I typically always recommend implants to be placed under the muscle.  I find they uphold better, look more natural and feel more natural.  I would suggest seeing a Board Certified Plastic Surgeon in person to evaluate you and discuss your options.   Best of luck to you.  

If your implants are placed in front of the muscle you will have less downtime and discomfort after surgery with no animation. However, you will have an increased risk of forming a capsular contracture. Placing the implants behind the muscle gives you the risk of an animation deformity. You should have a pretty result either way. It just depends on which risks are you willing to live with after surgery. Good luck!

Thanks for your inquiry and an excellent question. I am glad to see so many of my colleagues respond to it and they have already explained the pros and cons of above or under the muscle.  I have performed countless breast augmentations under the muscle on women whose occupations or pursuits demand upper body and pectoral strength.  My only observation is that they did have more pronounced animation deformity with certain actions due to there strong pectoral mass. Hope that helps.

Hello and thank you for your question. Advantages of  submuscular placement of the implant is less likelihood for capsule formation, more natural look and less rippling/implant visibility. As there is a layer of muscle separating the implant from the breast tissue, there will also be less interference with mammograms. I have done a lot of breast implants under the muscle in body-builders and athletes with success. I would avoid heavy lifting and other strenuous activities for 6-8 weeks post op, and after that you should be O.K. resuming your usual activities. See a board-certified plastic surgeon for a full evaluation and advice. 
Best wishes and good luck,

Pejman Aflaki, M.D. Johns Hopkins-trained double board-certified plastic surgeon

Hi. Yes, it is true that there are advantages and disadvantages of both techniques.  My preference for athletes or anyone with very little body fat is to use the submuscular approach.  When the muscle is on top of the implant, it makes the implant look less "fake" or round.  Also, with your type of activity, I would suggest smaller implants so they fit your body well, and also so they don't get in your way.  Best of luck!

As the previous Plastic Surgeons so eloquently described, there are advantages and disadvantages to placement of breast implants beneath or over the muscle.  I personally work with a large number of very fit women with very little body fat and usually a minimal amount of breast tissue.  As such, I generally prefer the sub muscular approach. This approach tends to produce a much more natural result because of the overlying soft tissue as compared to placing implants over the muscle.  The disadvantage is that when you are activating the muscle, the implants tend to "dance" or animate which some patients do not prefer.  However, in the long run my personal preference is strongly towards the sub pectoral approach and I feel that this would be a good recommendation for you.On that note, I actually operated on a patient in a similar profession this past year and placed the implants under the muscle.  She is extremely happy and has returned to full function with a very nice result!I hope that helps and wish you the very best!Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and Published Author

It is controversial whether to place implants under or over the muscle in extreme athletes. I’m not sure it matters. Just don’t go with big implants. You’re probably tiny anyway. Something like 250 cc would be my guess.