Over muscle or under muscle implants? I love to workout (photo)

I have triple crown body builders who start working out for their next competition by 6 to 8 weeks. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hi, thank you for sharing your question. While you can opt for either, based on your photo, I would suggest under the muscle due to your lack of soft tissue thickness. This will limit your complications.

Hello and thank you for your question. You would benefit from a below muscle procedure as the breast tissue is very thin and placing an implant above the muscle will cause a highly visible implant edge and an inferior cosmetic result.
Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

It is always difficult to tell over photograph however typically breast implants that are placed over top of the muscle require a significant amount of fatty or glandular tissue. I think that placing implants below the muscle of give you a more natural appearance. He should still be able to exercise regularly once your healed Although there is a risk for animation deformity, a slight release of the muscle can help with this

You need to make an appointment with a board-eligible or board-certified plastic surgeon that can properly discuss the risks and benefits of the different incisions and different pockets available for placing breast implants. The highest level of data that we currently have indicates that a subpectoral dual plane pocket (done correctly) through an incision in the fold underneath the breast (with a proper nipple to fold planning distance) has the least amount of potential problems. For someone with minimal subcutaneous tissue such as yourself, the ideal placement option would be under the muscle to provide the most soft tissue coverage of the implant.

Thanks for your question! I think that is a decision for you to make with your doctor. Personally, I prefer a submuscular approach for a more natural look. Either way, I'm sure you will get a great result. Good luck!

Thank you for your question.
I have many patients who are very athletic and are frequently working out who will get breast augmentations. My recommendation is to place the implants above the muscle. With a below the muscle breast augmentation, there is a risk of the implant moving laterally, towards the axilla area which is not a great aesthetic. After a few months of recovery, you will be up and running with your typical workout routine.

Thank you for your question regarding implant/muscle placement. In my experience, breast implants going under the muscle will require 8-12 weeks of pec muscle rest after surgery. It will be safe for you to resume any activity after that time frame. To be sure, see two or more experienced, board-certified plastic surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have a breast augmentation. I hope this helps.

Dear sstrawn,
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

At size 32, each 100 cc of implant corresponds to 1 cup size change. 220 cc implants would take you up to a C. The implants should be placed totally submuscular and they should not extrude inferior and laterally.

Best Wishes,

Gary Horndeski, M.D.