Is It a Good Idea to Have Saline Subpectural Implants Switched out for over the Muscle Saline?

I ask that because 3 years after I got the BA I came into the Army, where you have to do alot of push ups and pulls up. The implants seem to have greatly decreased my ability to do those exercises and do them comfortably. I'm hoping maybe if I switch to over the muscle, my the strength in my pectoral muscles will improve? does that sound like a good idea, and would it be worth the cost?

Doctor Answers 7

Submuscular to subglandular breast implant

Whether it is "worth" the cost has to be determined by you, the patient. It is possible that the submuscular implants are  producing a limiting effect on the pectoralis muscle function. However this might be due not only to the position of the implant but also how the original surgery was performed. Often the pectoralis muscle is surgically released to accommodate the implant size. This may weaken the muscle and simply repositioning the implant to the subglandular position may not solve the issue. The surgeon might have to surgical repair and reattach the muscle, if possible, to its original position. You should also review the pros and cons of subglandular position vs. submuscular.

Robin T. W. Yuan, M.D.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Implants suffering from pressure from active pectoralis muscle might benefit from replacement to a sub glandular position.

Occasionally patients find that sub pectoral placement will create problems will when the pectoralis muscle is actively engaged will. This is usually an aesthetic problem not a functional. Movement of the implants in the sub muscular to a sub glandular position can help this. However, you might be better with a silicone gel implant if the prosthesis is going to be above the muscle.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Implants usually better under the muscle

Every situation is different and there are some circumstances where going over the muscle is a reasonable choice, but it is difficult to predict whether changing from under to over would improve muscle strength. One clue would be whether you see "animation" of the breast with upward movement when you flex your pecs. That may mean that the muscle was cut (which is routinely done.) But moving the implants to over the muscle would require re-attaching the muscle with a long healing time before you could start strengthening, and you would lose the muscle coverage so the implants might not look as good.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 53 reviews

Risks of Breast Implant Repositioning For Potential Exercise Benefit Not Worth It

While in theory that sounds like a good idea, I would be very hesitant to incur the risks of surgery for such a small potential gain that is exercise-dependent and not aesthetic. There is far more that can go wrong than what there is to be gained...and that is gambling on the unproven theory that you will be exercise-tolerant.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Switching breast implant positions

It would NOT be a good idea to go from under the muscle to over for you in my opinion.  There is nothing you can't do with unders so I'd suggest just leaving them alone.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Exchanging Breast Implant Position from Sub muscular to Sub glandular Position?

Thank you for the question.

As you can imagine, precise advice would require in person consultation. Generally speaking, I would not advise most patients to have breast implants removed from the “sub muscular” position  and have them replaced in the sub glandular position. Although, based on your description, it may make sense to do so, there are many potential downsides of breast implants placed in the sub glandular position that you should consider.

Again, generally speaking, the submuscular 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.   

 I hope this helps.  

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Is It a Good Idea to Have Saline Subpectural Implants Switched out for over the Muscle Saline?

Although it might make sense that moving the implants might improve your strength, it may or may not be true either in general, or more specifically for you. 

If you switch the position, you should consider switching to silicone because of the feel of the saline implants above the muscle, and the possibility of ripples which might be visible. Discuss all the pros and cons with your surgeon. No one can guarantee the outcome you would like. 

Cost would be about the same as a new augmentation.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.