Thanks for your question-- and congratulations on your surgery! If your plastic surgeon has given you the ok to resume your exercise regimen, then that should be the most accurate test of whether or not you are ready. However, if you have concerns, or if your plastic surgeon is not clear on how strenuous your workout really is, then it's best to revisit the issue with him or her. Very heavy lifting and heavy repetitions can stretch the overlying tissues causing the implants to sag, to be malpositioned laterally, or to develop a mismatch between the implant and the overlying soft-tissue pocket. Your plastic surgeon should be able to tell you whether these activities are truly safe to resume at this point.
Erik Hoy, M.D.
You are right to be concerned - placing an implant under a well developed pectorals muscle can cause significant distortion of the implant when the pectorals muscle contracts, and with time this commonly causes lateral displacement of the implant. A dual plane approach means the muscle was released from some of the breast tissue overlying it, which will cause less upward, and possibly less lateral distortion with contraction. Unfortunately, I have often seen the muscle retract with repeated heavy lifting which can allow the implant to revert to a completely sub glandular space, which obviously defeats the purpose of placing the implant partially under the muscle in the first place. Bottom line - I tell my patients with under the muscle implants that repeated lifting for their chest and especially certain exercises can affect their result over time. I would recommend caution - if an exercise causes a lot of distortion of your breast, I would avoid it.
Caution is certainly warranted in your case. While it should be okay to gradually resume your lifting regimen, go slowly with any exercises that isolate the pectoralis muscles. Downward and lateral implant displacement is common when excessive contraction is performed in the early post-op period (first several months). Start out conservatively and then gradually increase over the next 2-3 months as tolerated.
Personally, I would share your concerns. In my practice, I ask patients to avoid “heavy” lifting and/or any other strenuous activity involving the pectoralis major muscle for as many months as possible after breast augmentation surgery. My concern is that the contraction of the pectoralis major muscle may “push” the breast implants inferiorly and laterally early on after surgery, before the breast implant capsules have had a chance to form. You may wish to address your questions/concerns directly to your plastic surgeon again. Best wishes.
I advise that my patients can resume regular activity and weight-bearing exercise at 6 weeks, however I also suggest beginning with a much lighter version of previous work outs if they were intense. Work your way up slowly to the level you were at before. Your Plastic Surgeon feels you are clear to proceed, but don't hesitate to share these concerns and specify the type of work out you are looking to do.
All the best!
I typically recommend patients refrain from any heavy lifting and weight training for 6 weeks. However each patient is different and each plastic surgeon has their own preference. You should discuss this with your plastic surgeon.
If your plastic surgeon who has cleared you to lift weights he or she is in the best position to make this decision. Generally speaking 6-7 weeks should be adequate recovery time. However start out very slow with light weights to see how you feel. Expect that you will see some contraction of the muscle which will push your implant down. Again start very light and if you feel discomfort stop and check with your plastic surgeon.
If your plastic surgeon is cleared you then you should slowly get back to your weight training. You may take more time to reach the level you were prior to surgery but you should have the ability to lift weights.
If your plastic surgeon has given you the "all clear", then you should be able to start lifting weights. I usually tell my patients that when they first start, they will be weaker than than they were pre-operatively; you may also experience a "weird" sensation to your chest when you lift. I would just suggest that you start slowly and work up to your pre-op goals -- initially, you may even find it awkward to perform a body weight push-up but with time, it will come back! Good luck!
I agree with your plastic surgeon. At 7 weeks, you should be cleared for full resistance exercises and your implants should do fine. Good luck training and congratulations on your breast augmentation!!
- Dr. Bryson G. Richards, MD