Breast augmentation - will going under the muscle disturb my active life?

I am 42, breastfed 2 kids. Most of the doctors I have spoken to recommend going under the muscle. However I enjoy cross country skiing and swimming (breast and crawl) verden much. Not compeeting, but still important to me. So I am starting to think that breast augmentation is not for me, unless going above the muscle. But then afraid that the result in time will be unsatisfactory? Am I overeacting or being realistic?

Doctor Answers 10

Breast Implant Over or Under Muscle

There are several advantages to going under the muscle. You will typically have a more natural appearance to the upper part of your breast. The action of your muscle will help massage the implant and keep the scar tissue capsule soft. The muscle protects the implant from the natural bacteria in your breast to decrease the risk of infection and capsular contracture. Going over the muscle does allow for more “lift” but if a “dual plane” approach is taken you can pair the advantages of both approaches. This is our preferred technique and we have performed it on Pilates and Yoga instructors, and other very fit women with no problems.

Breast Implants Above or Behind the Muscle?

You are being realistic. Implants, most notably large implants, can interfere with the sports you mention, but probably only in a very minor way. This is especially true if you are not competing. However, there does seem to be a growing trend to place the implants on top of the muscle to alleviate the precise concerns that you are raising. The problem is that if you are thin there is a increased likelihood that implants on top of the muscle can develop noticeable rippling. If you pinch the upper pole of your breast and you have less than 2cm between your fingers, I would  consider going behind the muscle. Otherwise, going on top of the muscle may be a very good choice for you. 

Post BBA Exercise


After an average of 6 weeks set aside for recovery, breast augmentation patient should be able to return to their regular fitness routine. While you are healing from implants placed under the muscle, activities like swimming and lifting anything over 10 pounds will have to wait but I allow my patients to ease back into their workouts starting at 6 weeks. I recommend that you discuss your goals and expectations with a board certified Plastic Surgeon to help you plan.

All the best

Breast augmentation recovery

After recovering from breast augmentation you will be able to resume the lifestyle that you currently enjoy.  Many prefer implants under the muscle because of the more natural look that it provides.  It will not keep you from continuing to participate in the activities that are important to you.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast augmentation

Thank you for your question.

You will need to expect some downtime from your active lifestyle during your recovery period but this will not permanently prevent you from returning to these physical activities that you enjoy. I recommend waiting at least 6 weeks before easing back into your regular fitness routine. However realize that your upper body may require some time to return to previous strength. 

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 64 reviews

Breast augmentation and placement

Thank you for your question. The benefits of placing your implant behind the muscle far exceed placement in front of the muscle. There will be no long term compromise in strength or abilities with implant placement behind the muscle. Best of luck!

Bruce Landon, MD
Tampa Plastic Surgeon
4.5 out of 5 stars 16 reviews

You can be active after breast augmentation

Hello karrik,

It is a wise choice to put the implant under muscle, if the subcutaneous tissue is insufficient. If you have enough subcutaneous tissue, the implant can be inserted under your breast tissue or muscle fascia. Submuscular(under muscle) breast augmentation does not affect your non-proffesional sports activities. You should avoid aggressive exercises for 6 weeks though. 

Kind regards,


Guray Yesiladali, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 8 reviews

No problem with activity

Most active sports people who are usually slim and who choose to have a breast augmentation will generally choose to go under the muscle to get a more natural result and this includes in my experience professional athletes - you will need to avoid those activities for 6-8 weeks then can return


Under the muscle is generally recommend for women who have inadequate soft tissue (breast) coverage of the breast implant.  I have many physical fitness and body competitors who have their implants placed under the muscle and they do fine.

IF you have enough, you most certainly can have the breast implant placed on top of the muscle.

Best Wishes,

nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.6 out of 5 stars 45 reviews

Breast augmentation - will going under the muscle disturb my active life?

Thank you for the question. There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well. 

I think it is in the best interests of most patients (including athletes) seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 

In the long-term, patients are able to return to all types of activity, including exercises engaging the pectoralis major muscles (such as push-ups, benchpress, Burpee's…).

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.    Best wishes with your upcoming surgery.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.