Do sub-muscular breast implants make your pectorals weaker?

Question

I am currently a B-cup and would like to increase a full cup size. I'm not looking for anything extreme just some added cleavage, but due to my smaller breast size it would look more natural to go under the muscle. I am an avid weightlifter including bench press/push ups/etc. Minus the fact of not being in the gym for over a month, do the implants cause your pecs to be weaker/unable to perform as well in general?

Nelson Castillo, MD · Answer

Thank you for sharing your question and best wishes on your upcoming procedure.  Placement beneath your muscle does cause a very small decrease in your pectoralis strength but which goes unnoticed by nearly all patients.  Hope this helps.

Daniel Barrett, MD · Answer

Dear Mica399,in case of sub-muscular implant placement you will probably lose some muscle strength but it should not have any effect on normal activities. Only professional athletes might have some problem with it. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Kenneth Hughes, MD · Answer

I have performed under the muscle augmentation in several professional bodybuilders and fitness individuals; and in general, the appearance of the augmentation is better under the muscle, particularly when the body fat is low.  However, there is a decrease in strength of the muscle to some degree.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Bruce K. Smith, MD · Answer

Yes, there is some weakness in bench press and push up type exercises following placement of a breast implant under the pectoralis muscle. In most cases the origin of the muscle along the fifth or sixth rib is divided to allow for a smooth contour of the lower pole of the breast. That is why I recommend that women not do exercises that isolate the pectoralis muscle when they have implants placed in the subpectoral pocket. You may be a candidate for subglandular placement if you desire to continue weight lifting/body building.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. Placing the implants underneath the muscle does tend to give a more natural result. With you being an avid weightlifter though, you might want to consider having the implants placed above the muscle. When placed under the muscle, part of the pectoralis muscle is detached from the ribs, but can make the muscle a little bit weaker. The vast majority of patients do not notice a long term difference, but someone like yourself might notice a little bit of weakness. Discuss these options with your surgeon and they should be able to give you advice on how to proceed. Best,~Dr. Sieber

Gary L. Ross, MBChB, FRCS · Answer

It has been shown that the muscle does atrophy but no evidence that it will reduce muscle power or affect strength.

Lawrence D. Chang, MD · Answer

Submuscular breast implants do require partially cutting the pectoralos major muscle which in effect may cause some weakness of the muscle. This should not affect normal daily activities but with heavier chest wall exercises, you might experience paradoxical lateral displacement of the implant. Most importantly is to see a board certified Plastic Surgeon for a thorough evaluation and discussion of options of implant placement below or below the muscle to ultimately achieve individual patient satisfaction.
I hope this helps and best wishes for a great outcome.

Raj S. Ambay, MD · Answer

Breast implants under the muscle require that we partially cut the chest muscle during surgery. That will create some weakness, and could be an issue for women who are in highly competitive bodybuilding categories. From the standpoint of looks, under the muscle implants offers a more natural appearance. I have had good results both under and over the muscle. The key is choosing the right patient for the right procedure and being honest with expectations. It’s best to seek an in person consultation to see what is right for you.

Tom J. Pousti, MD · Answer

That has not been my experience.  In my practice, patients report that they are able to return to full activity, with full strength over the long-term. Discuss your specific concerns with your chosen plastic surgeon. Best wishes.

Francis (Frank) William Rieger, MD (retired) · Answer

Quite simply, the answer is no.  Most breast augmentation procedures are done partially subpectorally, and so many of the patients are also very interested in body building.Good luck to you.Frank Rieger M.D.  Tampa PlasticSurgeon

Do sub-muscular breast implants make your pectorals weaker?

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