Age 30, Is there a submuscular option that impacts athletic performance less than others?

Hi HNM224,
it sounds like you had a prior submuscular augmentation. Subsequently, your implants were removed. It would be important to understand what was done with the muscle at the time of removal. Most submuscular options will routinely divide the rib origin of the muscle, to the junction with the sternum. Many surgeons will repair this muscle at the time of explantation. prior to another consultation, I would suggest getting the original operative notes for the augmentation, and from the implant removal, to share with your future surgeon.
For athletic women, a subfascial (below the muscle covering, but above the muscle itself) position can minimize alterations in muscle function. Alternatively,especially for very thin women, a split muscle technique can be used to provide muscle coverage in the upper inner breast where the implant is potentially most visible, but using the subfascial plane in the lower outer breast.
I hope this helps, and best of luck.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Thank you for your question regarding implant placement.

There are 2 options when placing a breast implant: submuscular (under the muscle) or sub glandular (above the muscle).

I recommend talking about this with your plastic surgeon as both have their own pros and cons. Your surgeon knows your history and your goals best and can help decide what is best for you.

Hope this helps!

For the right candidate, placing the breast implants above the muscle but under the fascia ( the lining layer that covers the muscle ) can provide great alternative to underneath the muscle placement (submascular) . This technique is different than under the gland placement (sub glandular or simply above the muscle) since the surgeon will need to meticulously place the implants accurately underneath the fascia but above the muscle.

Thank you for your question. With all sub muscular options, the muscle is lifted off of the chest wall to varying degrees. However, it is ALWAYS lifted. Another option, for you may be putting an implant in front of the muscle, and combining the approach with fat grafting, a hybrid breast augmentation. This has the benefit of having an implant that does not require lifting of the muscle, and the fat grafting does a good job of camouflaging the implant while adding some additional volume so as to be able to use a smaller implant. Good luck.

Dear moriahh20,
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

Thank you for sharing your question. Assuming you were placed underneath the muscle the first time due to a paucity of natural breast tissue, there isn't a "different" sub muscular option. Some patients may be candidates for above the muscle, but below the pectoralis muscle fascia, but sufficient breast tissue must be present in order to accomplish this.

Implants are placed in 3 places. One is behind the breast which will not affect your muscles, but may be more noticeable. They can be placed behind the muscle for better coverage and support and more upper breast fullness and less sagging over time, but may interfere with activities. Or, they can be placed behind the fascia, the firm covering of the muscle, but not the muscle itself, for some coverage and less muscle interference. Not all surgeons use the subfascial plane. If you have enough tissue, place the implants behind the breasts only.

Hi moriahh20, excellent question. The three placement options are: submuscular, subglandular, and dual plane (or partial muscle coverage). If you're bothered by submuscular implants impacting your performance, consider having the implants placed above the muscle. Hope that helps.

Unfortunately, lifting the pectoralis muscle to place the breast implants results in decreased strength which lasts for 6-12 months
Placing them sub fascial does not really give you the submuscular benefits. Subglandular is great, but the potential for visualization of the implant is always a concern
Best wishes.
Dr. Taranow