I Am a Female Powerlifter and Train with Heavy Weight. How Will Implants Affect Upper Body Strength?

   As a bodybuilder and as an athlete who has bench pressed 600 lbs, I probably have a different view on this question.   If your goal is to become the strongest you can become, there is NO doubt that there will be a decrement in strength with submuscular augmentation.  If you have enough tissue above the muscle to camouflage the implant, then go above the muscle.  If you have very little tissue or diet down at certain times, you should consider submuscular implants with the understanding that there will be a small decrease in strength and that there may be a small chance to laterally displace the implants.  I have put submuscular implants in women who have bench pressed almost 300 lbs without ill effect, but it is always better for the patient to be fully informed.  Kenneth Hughes, MD Los Angeles, CA

In power lifters the pectoralis muscle can be bulky so you might want to consider using a gel implant place just underneath the breast gland so you will not have muscle movement of your implant when you are lifting.  This should not effect you muscle strength after your initial post op period.

 

Good luck,

Dr T

As a power lifter you have 2 options each of which has its pros and cons.  Option one is to go below the muscle.  Main advantage being NO affect on your muscle strength nor function.  But several major downsides.  First is rippling and potential visibility of the implant.  This leads to the "fake" look.  More importantly is the increased risk of capsular contracture.  Alternatively is to go under the muscle.  The benefit being increased coverage of the implant , a more natural look and reduced capsular contracture.  As for how it will affect your muscle no one can tell.  There are many fit and active women with sub muscular implants who don't notice any weakness.  That being said no one can be sure.  Additionally your implants WILL move when you workout.  I hope that helps.  

This question has actually been studied scientifically.  After 4 weeks, the study showed no change at all in pectoral strength compared to pre-op testing, even with sub-pectoral implants.

 

The one thing you mostly need to consider is whether you place your implants above or below the muscle. When I see fitness patients who do lots of pectoralis work I suggest placing implants above the pectoralis muscle. This will avoid the animation deformity that you will see when under the muscle and performing heavy lifting exercises. It is very rare that I push patients to have implants above the muscle, but you are one of them. You need to clearly identify the pros and cons with your surgeon. You do have more of a risk of rippling effect when above the muscle. But again, if you are doing lifting exercises as you describe all the time what will happen is slowly that implant will be forced into the armpit area. It is impossible over time to keep the implant from doing this when the implant is below the muscle. It can happen over time above the muscle as well, but you are more likely to maintain a better pocket above the muscle with heavy lifting. Silicone for sure!

Thank you for this interesting question.

1. Studies have been done with regard to muscle strength after a breast augmentation.  While subglandular patients recover a bit more quickly, both groups of women return to lifting the same weight as prior to the surgery suggesting no loss of muscle strength.  The implants a quite tough and you will not injure them.  I do believe, however, that repeated contraction of the pectoralis muscle will lead to lateral migration of the implants since the pectoralis is attached to the sternum (breastbone) and to the clavicle (collar bone) and has no attachment laterally.

2. The other issue is over or under the muscle.  Most fit women and especially body builders have a lower percentage body fat than patients who are less athletic.  Less body fat offers less coverage for the implant and may lead to increased implant visibility.  This will be less with silicone than saline but can occur with both. This is a discussion you will need to have with your plastic surgeon and it really depends on how much potential visibility you are willing to accept.

3. The other issue you did not mention is implant movement with muscle contraction. This is a potential issue when the implants are under the muscle.  Some patients experience more implant movement than others. Again you will have to discuss this with your plastic surgeon and decide how much if any movement you will be willing to tolerate.

Best of luck.

In general I recommend above the muscle breast augmentation for patients that exercise heavily with their upper arms or are professional body builders.  It is possible to place them under the muscle and look nice but in the gym you will usually see movement of the implants upward and out toward your armpit as you flex the pectoralis muscle during weight lifting. In some small number of cases it may even cause displacement of the implants into a position that looks too far out to the side because of scarring in this position.  Most everyone else I recommend under the muscle because of lower chance of contracture (hardening).

After you heal, you should be able to go back to power lifting and should be able to lift the same amount of weight.

There have been multiple studies investigating muscle strength after an augmentation.  I would not advise lifting or bench pressing for the first 6 weeks.  A potential problem with submuscular implants may be a gradual lateral migration of the implants.   If you are a powerlifter and have a well developed pectoralis muscle then some consideration may be to place the implant in the subglandular space.  

An Anatomic Form-Stable cohesive gel implant in the subfascial position will not affect muscular function.  This would be your best option.  If you prefer submusclar placement it will probably take 3-6 months to regain your muscle strength.