Should I swap to over the muscle? (Photos)

I had my BA & BL under the muscle 6 months ago. As time passes my breasts look more lumpy, square and misshapen as my pec muscles clamp down on the implants. I go to the gym a lot and have been told my pecs are quite thick. I do have a capsular contracture on my r) and the pec major needs releasing to allow the implant to drop. My question is, should I consider swapping to over the muscle implants for a more aesthetically pleasing outcome? I need corrective surgery and want to avoid further ops.

Doctor Answers 4

Implant placement

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Your  underlying problem is that your implants are now too high for your breast tissue.  Your breast tissue has settled or dropped now making this problem more noticeable.  It is unlikely you have capsular contracture as it is too early for this to have to developed.  The best solution is to have your implant pockets adjusted so they sit in the correct position in relation to your breast tissue but leaving them in a submuscular pocket.  They should stay under the muscle as changing to over may lead to problems with the muscle attachments and blood supply.

Switch to above the muscle

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Your question touches on a very controversial area.  There's definitely a split in thinking about above or below the muscle implants. This is especially true for bodybuilders. The reason this can be a difficult decision is this. Bodybuilders have thick muscles and are more prone to have a long time to settle  however bodybuilders also have very little subcutaneous tissue and fat. Therefore the implants can be much more noticeable and have rippling and wrinkling which is equally undesirable.  A switch to a different plane is certainly an option however you need to be evaluated by a board-certified plastic surgeon before this is done 

Andrew Kaczynski, MD (retired)
Sacramento Plastic Surgeon

Switch to over the muscle?

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I agree that in very athletic patients, especially body builders, the best place for implants is above the muscle for the reasons you already mention.  Given that you already have a right capsular contracture at 6 mo, you will need surgery to correct it,  and I would certainly recommend that you speak to your surgeon about replacing the implants above the muscle

Paul Silverstein, MD (retired)
Oklahoma City Plastic Surgeon

Implant Placement

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In the vast majority of my athletic patients the implants are placed on top of the muscle for the reasons you mentioned.  This is a common complaint with crossfit, pure barre , yoga, tennis , and more.  Discuss this option with your surgeon.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

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.