I Am an Avid Rock Climber; Will Going Submuscular Affect my Strength/distort my Implants? (photo)

Hello,

Thank you for sharing well-taken photos.

Based on what you have expressed and the type of your activity, it seems that the best way to go is to have a submuscular silicone implants that will provide you with a natural look and the least distortion possible.

Also, submuscular implants should have little to no effect over the performance of your pec muscles hence your overall performance as a rock climber.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.


I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.



Dr. Sajjadian

Partially subpectoral breast augmentations have the advantage over submammary breast augmentations in very slender, muscular women.  These advantages are:

1.  less chance of rippling

2.  less chance of capsular contracture

3.  easier to read mammograms

4.  more natural appearance and less chance of seeing the edge of the implant

I have done breast augmentations on many competitive athletes including rock climbers, and I have found no loss of strength or distortions over time. 

The increased risk of capsular contracture when placed over the muscle can lead to unusual distorted breasts that are uncomfortable as well as unattractive.  This alone would make me recommend submuscular placement even in a rock climber. 

All that being said, it is important for you to find a Board Certified plastic surgeon with a great deal of experience in breast augmentations on athletes.  Be sure that you feel comfortable with this surgeon and then go with what he or she recommends.

Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity

Generally speaking I prefer to place the implant under the muscle when I encounter someone who is thin or has very minimal breast tissue. In your situation, if you are interested in only adding a smaller implant to go up 1 cup size, then I will recommend a silicone gel implant placed above the muscle. You wouldn't have to deal with compromised muscle strength or distortion from muscle movement. Another good option is to use anatomical shaped round based silicone gel implant which will get you great projection over breast mound but minimize excessive bulging of the upper pole. Most of my fitness patients are having this type of breast enhancement with minimal risks of rippling or unnatural augmented look.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Thanks for a great question.  I almost always reccommend a submuscular position even in very active women, but your rock climbing passion is a hard to comment on, because I do think the pectoralis muscle is weakened some and more importantly-animation deformity or motion of the implant with use of the pectoralis muscle is not an uncommon problem.  Your other option is to place a silicone implant over the muscle.  Secondly though I do not personally perform this operation, you could seek the opinion of a surgeon who specializes in fat transfer to breast.  Hope that helps, good luck.

Placing an implant under the muscle usually does not cause any significant weakness, but you may be the exception. Avid rockclimbers may find that there is a small reduction in strength after a submuscular implant. More importantly, you may get a dynamic contraction deformity in which your implants get distorted with muscle contraction. You are probably best served by a subglandular implant.

It's a good question.  One study published in 2004 examined women who had submuscular implants and found there was no loss of strength.  Certainly I have treated many women who are physical trainers and athletes and this has not been a problem for them.  However, it is true that exertion of your pecs can temporarily cause some visible flattening of your breasts.  If you want to be assured that won't happen, you could elect to have your implants placed about the muscle.  You already have a substantial amount of breast tissue, so they should not look too obvious, especially the smaller size that you have in mind.

   Dear cgood26,

   In my practice I spend a great deal of time discussing the pros and cons of going above or below the muscle in very active athletic women. Going below the muscle will leave you weaker to some degree no matter how careful the surgeon or how small the implant. I have also found that very athletic patients with well developed pectoralis muscles may have some  flexion contraction deformity while exercising. Going above the muscle in your case may be the best option for you given your high expectations about exercise and by looking at the photos you provided. However, your surgeon should also go over the risks of going above the muscle such as higher capsular contraction and rippling rates to name a few. If you haven't done so already, seek opinions from several BS surgeons in your area and choose the one that makes the most sense to you and your situation. Good luck. Dr G.

The long term results are significantly better with the submuscular implants. There is probably some loss of strength with the subpectoral placement.

In general, most of my patietns are very active and going under the muscle in thin patients is usualy the best way to go.  It usually does not impact overall strength once things have healed.