Over or Under For Implants if I Want to Get Into CrossFit?

I am getting into Cross Fitness and as I am researching I find where some say you should get your implants over the muscle and others say under. Then some say get small implants while others say size doesn't matter. For pull ups, push ups, and things of that nature would you say unders or overs and what size? I am 4'11 and weigh 120 lbs. I'm 32/34 A/B deflated from breast feeding 5 kids. I want 450-500cc's Saline unders for a DD/DDD. Should I get over or unders and what size for cross fitness?

Doctor Answers 6

Minimize implant size by simultaneous Mini Ultimate Breast Lift

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Your breasts are a 32/34 A/B and deflated.  I do not believe it would be possible for you to accommodate 450 to 500 cc implants under the muscle.  You would be better off with a smaller implant placed retro-pectorally.  There is a new technique called Breast Augmentation with Mini Ultimate Breast Lift which will lift your areola, elevate your breast tissue and allow implant placement.  This will give you the look you desire of large breasts using smaller implants.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Best Breast Implants if Planning Cross Fitness?

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Thank you for the question.

There are pros and cons to the placement of breast implants and the “sub muscular” position versus the "sub glandular position”.  There are also pros/cons associated with the use of saline implants versus silicone breast implants. I will try to outline some of the differences here;  you may find the attached link helpful as well.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.  Also, the immediate recovery period may be  more comfortable  after sub glandular breast augmentation as compared to sub muscular breast augmentation surgery.

 In your case, I would probably suggest these sub muscular ( dual plane) presentation procedure understanding there will be a delay of many months before you can return to pull-ups, push-ups…  Remember also that there  probably will be some movement of the breast implants as your pectoralis contracts during exercise.  Also, given that you probably  will have very little adipose tissue/soft tissue coverage of the breast implants,  you may want to consider the use of silicone gel breast implants.

In regards to the use of saline versus silicone breast implants, the type of implant used may Influence the final outcome  of the procedure, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.

 In regards to breast size, it will be important to communicate your goals carefully with your plastic surgeon. I prefer the use of goal pictures in this communication process. I find that  this communication process is more precise than the use of cup size description (“DD/DDD"may mean different things to different people).  Make sure that the size of breasts that you wish to achieve will not get in  the way of the strenuous exercise program you are planning.

I hope this helps.

Cross fitness training favors a smaller subglandular implant

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There are many factors in you question and trade-offs will come to bear. If cross training is your dream, then submuscular implants will deform with muscle pressure and cause embarrasment. Next is size, and your small frame with a DD-DDD goal might be too full for the amount of tissue to cover and blend with the implant. Finally, a larger saline implant may not feel or perform as well as a silicone implant as far a show through or ripples. Many conflicting issues will take a careful consultation to sort out.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Implants Over or Under Pectoral Muscles

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The size of the implants that you seek are more likely to cause complictaions than the placement. If you have thin skin you should have your implants placed underneath the muscle, and if your skin is thick you can achieve positive results over the muscle. Heavy weight lifting is really the only time when activity will impact sub-muscular implants.  Most patients with sub-muscular implants are still able to perform pushups and other exercises.
You should set up a consultation with a board certified plastic surgeon.


Jaime Perez, MD
Breast Implant Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Implants in cross fit training

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Implants to take you pu to a DD/DDD would put you in territory of patients iwth your height and weight who typically seek breast reduction because of back, neck and shoulder pain as well as bra strap grooving. I think you have to analyze your goals, i terms of fitness and training, and come to a resolution in your own mind as to priorities. I think that your athletic goals may be compromised by large implants, not to mention the heightened risk of complications.

Implants in cross fitness training

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I think you have some conflicting factors. First, you want to go very large compared to your small frame and relatively small amount of natural breast tissue. That will produce a higher incidence of long-term complications.   Also, the larger the implant, the less it will actually be under the muscle. Second, your high degree of physical/muscular activity may suggest that going subglandular ( i.e. over muscle) would be more advisable. Finally, the more your final breast is comprised of an implant, the more it will act like the implant you choose. This would suggest that a silicone implant would feel more natural than a saline, but placing this in the subglandular position will incur a higher chance of capsular contracture than a saline implant. 

You should go over all the options and side effects/complications with your plastic surgeon. Breast augmentation in your situation is an imperfect procedure.In general, decide what side effect/complication you can live with and choose the smallest implant that will make you happy.

Robin T.W. Yuan, M.D.


Robin T.W. Yuan, MD
Beverly Hills 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.