Under or over the Muscle For Natural Appearance on Athletic Body?

Breast implants are usually placed underneath the muscles to ensure natural-looking results. But if you have to flex your muscles on stage as a bodybuilder, you may consider sub-glandular implants.

Hi there-

I personally believe that unless you are a competitive body builder, it is in your long term best interests to have your implants placed under your pectorals muscle, despite the possibility that this will cause some motion deformity with contraction of your pec muscles. The benefits simply outweigh this small and uncommon drawback for the vast majority of patients, especially if you are interested in a more natural appearance.

Please be aware, however, that once of the greatest errors you could make is to investigate and shop for a procedure you think you want, and then find a surgeon willing to do it on you... Your chances of being safe and ending up happy with your outcome and experience will be significantly higher if you instead spend your time and energy finding the very best surgeon you can (based on education, training, experience, talent, and outcomes), and THEN worrying about the details of the procedure.

If you choose a great surgeon, you will find that the other details will more easily fall into place.

 

Breast augmentation can be performed with implants placed over the muscle (subglandular) or under the muscle (submuscular).  Different surgeons have different preferences. For the majority of patients submuscular placement of implants have advantages that include better implant coverage especially in thin patients with little breast tissue and there is also a reduced risk of capsular contracture which is increased breast firmness or hardness.  

The question we would ask is do you have an athletic build, or are you athletic and competative. We do favor submuscular placement for most as implants have better coverage and a softer upper edge, However submuscular implants in an athlete can suffer from motion when the chest muscle is flexed, and create a problem for you. Both can look very good, just trade-offs to consider with your surgeon.

Thank you for the question.

Although patients who have breast implants placed in the sub muscular ( or dual plane)  position may experience more discomfort during recovery, I still think it is in your best interests (and that of most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” 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 in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

I hope this helps.

I often place implants in a dual plane because patients who are very thin need the additional superior pole coverage that a dual plane provides.

You said you have an “athletic build, but did not say whether you were athletic. Assuming you are, then you should get the silicone implants on top of the muscle. In an athletic person breast implants below the muscle are deformed by arm use and have a higher rupture and dislodgement rate. You should also get a medium or lower profile to give you the most natural look.

 

Most implants placed under the muscle are really in two planes (dual plane approach) because the lowest portion of the breast implant is not covered by muscle. I believe that this is the preferred approach for a thin, athletic build because there is usually not enough body fat to cover the implant. The only disadvantage is that the implant is visible for the brief period that the pecoralis major muscle is contracting during weight training with this muscle. Other advantages, including beter long-term support more than outweigh this one issue.