Weight lifting with implants - above vs under muscle?

Thank you for your question. I always recommend implants to be placed under the muscle. They look, feel and last longer that way. Above the muscle implants tend to droop over time and have a chance of seeing the defect of an implant more. In regards to working out once you get through the recovery period you should be fine. You may have to start off slow and increase the lifting over time. Every surgeon will have their own protocol they wish you to follow when it comes to recovery and working out. I would recommend speaking with a Board Certified Plastic Surgeon in person to evaluate you and discuss your options with you. Best of luck to you.

Hello!!!Thank you very much for your question.I recommend the implants over the muscle.Otherwise,you will not feel comfortable whenYou lift the weight and the implants move upward.Also if the implants are under the muscle,withThe weight litf,over time, the pocket were the implant is placed will enlarge too much.Best Regards!Dr. Alejandro Lev

Hello,
Thank you for the question.
Typically, placing the implants above the muscle (subglandular plane) can help minimize animation deformity (when implants move during weightlifting). However, not everyone is a candidate for above the muscle breast implant placement because if the breast tissue are very thin, implant rippling may be more pronounced in the upper pole of the breast.
I would encourage you to seek a consultation with a Board-Certified Plastic Surgeon to further discuss your options, specific techniques, concerns and expectations.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

I advise my patients that at three weeks after surgery, it’s OK for you to do aerobic activity (treadmill, stationary bike, etc.), running and lower-body weight training. Women are usually comfortable doing arm exercises (upper-body weights) starting about six weeks after surgery. Among my patients are Triple Crown bodybuilders and kickboxers who go back into competition after getting implants. They start with light training at six weeks and heavier training after eight weeks. None of their implants has deflated. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Placement of the implant on top or underneath the muscle is something we always discuss with patient with history of competitive body building of any kind. It is better to place implant on top of the muscles to avoid dynamic deformity (which may be visible if implant is placed underneath the muscle); on the other hand, countour of the implant may be more visible in subglandular location. Amount of breasst tissue that you have may be ultimately the factor to decide about placement. Hope this helps.

Thank you for your question. I perform breast augmentations on many figure and fitness competitors as well as body builders. A large portion of my practice is dedicated to revisionary breast surgery. After 28 years in practice and performing over 5000 breast surgeries, I have some perspective for you. The highest complication rate associated with breast implants is associated with placing them on top of the muscle. Over the years, I have fixed so many breast implants that have been placed on top of the muscle that just do not hold up over the years and invariably will require a revision. On the other hand, a properly performed breast augmentation under the muscle/dual plane has a much lower complication even in muscular women. Best wishes to you.

Dear dannie121479,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Excellent question. Windowshading deformity is common after submuscular implant placement. I prefer subfascial or subglandular placement in women who are very active at the gym. However, you need to have enough of your own breast tissue to cover the implant itself. The typical teaching is that you need at least 2 cm thickness of your own breast tissue to be a good candidate for this technique.

Clearly an examination in person by a board certified plastic surgeon would be required to properly evaluate you and advise you on your options and recommended treatment plan. That said, whenever possible, in my competitive body building patients, whenever possible I prefer a subfascial placement to minimize the risk of animation deformity when activating or flexing your pecs. Depending on how much breast tissue you have, there is a risk of implant visibility and/or rippling, and therefore a more highly cohesive implant may be in your best interest. However, the higher the profile, the greater the risk of an artificial look. Another potential option to consider is an anatomic or shaped device (now only available by Sientra and Mentor).

Again, an in person consultation with a board certified plastic surgeon well versed in breast augmentation would be your best next step. Make sure that your plastic surgeon seems to share your own sense of aesthetics before and during your consultation, based on his or her Before and After gallery, and do your research with regard to patient reviews, etc. Don't be reluctant to consider a second or even third opinion. The best chance for success is a great first operation as opposed to revision surgery. Best of luck to you.

You can weight lift with implants in either location, once cleared by your surgeon. If your implants are under the muscle, you may notice some shape change to your breast and implant movement when lifting weights as the muscle contracts on the implant. Patients involved in body building and fitness contests may opt for implants over the muscle to avoid this motion when competing.