Suggestion over or under muscle for female weight lifters?

I want to achieve a 36D with silicon gel implants, high profile. (stats 36a 5'5 135 20%bf) I life 6 days out of the week. I had a consultation and was told that I should go over the muscle because if I went under if would gradually create pockets and my implant move outward. For the women who go under what are the chances of this happening? I was also told that if I got too big that it will cause a rippling affect? Will this happen anyways if I continue to do chest workouts and gain muscle?

Doctor Answers 10

Breast Implants In A Weightlifter

Thank you for your question.  I have many bodybuilder's, trainers and fitness models in my practice.  The consultation is usually quite extensive.  There are differences between someone who works out a lot vs. someone who is a true bodybuilder. I will review all of the pro's and con's of each approach and allow them to make the best educated decision for themselves.  I also find it important to find out their work out routine and their short and long term goals.  For example, someone who works out a lot, but developing their chest muscle is not of that importance, then a dual-plane under the muscle approach does very well.  Another option is a sub-facial approach to placement of the implant.  This can give you a little of the advantage of under the muscle for coverage and not as much animation and implant displacement as fully under the muscle.  I advise you to seek out  a surgeon with experience in this area and have a good informative discussion.  Good Luck!

Orlando Plastic Surgeon
4.8 out of 5 stars 52 reviews

Textured implants best

At size 36 A each 200 cc’s of implant corresponds to 1 cup size change. To achieve a D would require 600 cc implants. 600 cc implants will not fit retro-pectoral, will extrude inferiorly and laterally requiring revision. I suggest you consider a smaller implant that would be more stable. I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. Textured implants are more likely to stay in position because they are adherent and will be less likely to extrude from compression of the pectoralis major muscle.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Breast Implants in Weight Lifters

The information you have been given is totally correct. I would never put implants under the muscle in someone who uses their arms like you. Going too large can also cause major long term problems. It sounds like you have a very smart surgeon. Listen to him/her.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast implants placed under the muscle can work well for weightlifters

You are posing an important question.  There are always concerns that professional bodybuilders and weightlifters will be bothered by the animation or displacement of the breast implants placed beneath the muscle during weightlifting and bodybuilding activities.

However in my experience treating many bodybuilders and weightlifters is that the numerous benefits of placing the implant under the muscle outweigh the disadvantages of animation.  I have never seen one of my patients who lifts weights find that their implants are displaced laterally by stretching the pocket.

The benefits of submuscular placement are better coverage of the implant, less visibility of the implant edge, and most importantly a reduced chance of capsular contraction.  If you decide to have Sub-glandular augmentation I concur that textured implants are likely a good choice to attempt to avoid capsular contraction.

Weight lifter

Several issues here. Most surgeons in the US prefer under the muscle placement for several reasons. The main drawback is "animation" or change in breast shape with arm movement, and this can be pronounced in weight lifters and body builders. The other issue with that group is the downward and outward shift of the implants caused by the strong pectoral muscles. 

Many of us will consider above the muscle placement in lifters. However there are drawbacks, some of which involve unnatural appearance, especially in a woman with little breast tissue who wants larger implants. 

Consider using the newer highly cohesive implants that have a more natural breast shape engineered into the implants.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Implants for body builders

If you wish a modest augmentation a sub-muscular augmentation does well. If the result you wish is quite full and you wish quite a bit of upper body work think about highly cohesive shaped over the muscle implants. Round high profile implants might give too much show through.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Breast augmentation for body lifters

Great question.
After doing about a half dozen subglandular implants on professional body builders, I have moved back to doing subpectoral augmentations.
Instead of using smooth silicone implants, I now use textured implants.
This implant allows me to have a lot more control on the pocket.
Even with a lot of activity, the implants should not migrate.
This approach avoids all the negative issues associated with subglandular implants.
Patients who have had this procedure are extremely happy.
Hope that helps.

Marcelo Ghersi, MD
Miami Plastic Surgeon
5.0 out of 5 stars 149 reviews

Breast implants in weight lifters

You ask good questions that are hard to answer without seeing you.  I, too, typically recommend that weight lifters who do a lot of pec workouts at least consider going over the muscle.  I have seen many women over the  past 20 years with subpectoral implants who developed a downward and lateral drift of their implants due to chest workouts.  However, there is definitely an increased risk of visible rippling; especially if your upper breast "pinch test" is less than 2cm. 

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

BA in weightlifters

Thank you for your question. This is becoming a common issue with women who are interested in a breast augmentation and are very physically active. A formal consultation would be best to give a honest opinion, however, I suggest placing the breast implants over the muscle in women who wish to continue working out their chest muscles. This will help avoid developing animation deformity and reduce the risk of having the implants displaced laterally.

C. Andrew Salzberg, MD
Westchester Plastic Surgeon
4.8 out of 5 stars 49 reviews

Weight lifters

I have tried everything with weightlifters and what I find the most useful is still under the muscle with a small implant, my reasoning is I would trade animation deformity from the most obvious looking breast augmentation which happens when an implant is under such thin tissue.

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
4.9 out of 5 stars 72 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.