If I have overdeveloped pectoral muscles, will that affect the outcome of under the muscle breast implants?

Question

I am scheduled for BL/BA under the muscle. I am slightly stressed as I spent 12 years working professionally as a contortionist and feature Pole dancer. I have moved on to different professional work so I'm not doing it 8-12 hours daily anymore but I do still compete once a year. My right side is probably significantly stronger. If my PS opens me up and my muscles are built like the Hulk, is this going to affect my overall outcome? I worry about animation deformity or implant never dropping.

Austin Hayes, MD · Answer

Thank you for your question. I would speak with your plastic surgeon about your concerns. Every surgeon has a different technique, but I find in my office that placing implants under the muscle, in a dual plane, results in a minimal animation deformity. My patients are able to return to all activities, including those that are extremely strenuous. As you know, placing implants under the muscle gives the implant another layer of camouflage to decrease the chance of visible rippling, decrease palpability, and decrease the risk of capsular contracture. Good luck with your upcoming surgery!

Daniel Barrett, MD · Answer

Dear lennev,                        
  
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 it’s not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle. 
  
If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
  
                                       
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery
  
Member, American Society of Aesthetic Plastic Surgery

Nicholas A. Flugstad, MD · Answer

Great question. Normally this is not an issue with submuscular augmentation, even if you are muscular. You can expexct some movement of your breasts when you move your pecs (animation deformity) anytime the implants are under the muscle. For some folks, depending ont their build and breast size, over the muscle augmentation is also possible. Best to have an in depth discussion with your American Board of Plastic Surgery certified sugeon.

Andrew Barnett, MD · Answer

The answer is... maybe!  Depends on how developed your pec muscles are and how asymmetric they are.  I have quite a few body builders in my practice and they are the only ones that I will consider placing implants above the muscle. That's because when they are posing the pec poses definitely cause implant distortion. However, because they are also "ripped" (major weight loss to show muscle definition) frequently sub glandular implants don't look great.  For most women, unless they are using steroids (a no-no) their pec development is not large, and won't impact the shape of the breast.  Also keep in mind, that most of the time when doctors tell you that they will place the implants under the pec muscle, the pec will only cover the upper 1/3 to 1/2 of the implant - the remainder of the implant is below where the pec muscle ends.  If you have very dynamic muscles, this can be addressed at surgery by cutting the lowest insertions of the pec muscle at the breast bone (sternum).  This will generally not affect muscle function.  All this said, an experienced breast surgeon can walk you through your options and give you a good idea of how the different approaches will impact your personal situation.

Ronald V. DeMars, MD (Retired) · Answer

Your surgeon probably discussed with you that "under the muscle" only means the top half of the implant is under the muscle, the bottom half is not. This will dramatically minimize any animation deformity. That is called the Dual-Plane positioning. Most surgeons are using this positioning as it  the most natural of alternatives when under the muscle. The only way to eliminate animation deformity is to go on top of the muscle but this can give a very bad look to slender women in many circumstances. I have done all my body builder patients with the dual plane technique for years and they do very well. You will too. Also, since the bottom of the implant is not pushed up by the muscle, there should be no issue with not dropping into position.

If I have overdeveloped pectoral muscles, will that affect the outcome of under the muscle breast implants?

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