4'11" athletic build, 110lbs, low body fat. Over or under the muscle? (Pohto)

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thanks for the question.
While I cannot speak to your other consultation, a few things come to mind with implant plane choice. Breast augmentation is still commonly performed both below and above the muscle depending on the patient's anatomy and preferences. If you have thinner tissue (ie you are skinny), placing the implant beneath the muscle is a nice way to cover the upper portion of the implant and avoid implant visibility. To the contrary, going under the muscle can increase your risk of "animation deformity" which is when the implant / breasts move abnormally when the pec muscle is flexed. As a body builder, this may be more of a consideration for you given your increased muscle mass. You appear to have minimal ptosis (natural breast hang) and depending upon your aesthetic goals, you may be a candidate for submuscular augmentation alone (without lift).
I hope this helps!