Under or over the muscle implant placement - which would be best for someone who surfs?

When implants are placed underneath the muscle, the origin of the pectoralis major muscle from the 6th & 7th rib is often taken down and this will weaken the strength of the muscle. Also, in the retro-pectoral position, contraction of the muscle extrudes the implant inferiorly and laterally and this commonly leads to implant displacement and a revision is needed. When implants are placed in front of the muscle, it often cuts the nerve supply to the nipple and decreased sensation is the result. Also, in front of the muscle, the only thing holding up the implant is the skin envelope and often times the skin envelope is quite thin and rippling can occur and can be visible. Unfortunately, you have not provided photographs. However, you may benefit more from a lift with fat transfers rather than implants.

Best Wishes,

Gary Horndeski, M.D.

For someone who surfs, under-the-muscle (submuscular) implant placement is generally a better choice. Here’s why:
1. More Natural Look and Feel: Placing implants under the muscle allows the chest muscles to cover the implant better, which can create a more natural contour, especially in active movements like paddling.
2. Reduced Risk of Implant Visibility and Rippling: Since surfing often requires intense upper body movement, having the implant under the muscle helps reduce the visibility and rippling effect that can occur with over-the-muscle implants.
3. Long-Term Stability: Under-the-muscle placement offers more support for the implant, which can prevent it from shifting, an advantage in high-impact activities like surfing.
4. Lower Interference with Pectoral Muscles: For someone who uses their pectoral muscles regularly, such as a surfer, this placement minimizes interference with muscle function and reduces the risk of complications like animation deformity, where the implants move unnaturally with muscle contractions.
There are a few downsides, such as a potentially longer recovery time, but for someone with an active lifestyle, submuscular implants are usually the preferred choice. Consulting a board-certified plastic surgeon who understands your lifestyle can give you the best guidance on implant placement.