Would you be able to see implants if placed subfascial? Can you lift heavy weights (squats) with intramuscular placement?(Photo)

I am 5'4 135. Very active and lift weights regularly. I am considering either 379cc or 434cc round implants with lipo and fat grafting to my hips. I am going with implants because a BBL would not give me the results I am looking for. My biggest concerns are being able to manipulate the implant and them visibly looking like cones projecting out. Thank you for the input!

Doctor Answers 5

Would you be able to see implants if placed subfascial? Can you lift heavy weights (squats) with intramuscular placement?

This is a great question as there are several ways in which a butt implant can be placed for your augmentation. The options that currently exist are above the muscle, subfacial, intramuscular and submuscular placement of the implants. For the most part they each have their advantages and disadvantages.

Placing the implant completely above the muscle is done less commonly as the implant is more likely to shift and it releases some of the natural attachments of the buttock. Submuscular was popular in the past as it created a buffer for the implant in an attempt to give patients a more natural appearance and feel to their butt augmentation. It has loss popularity as it can put people at risk for complications if the implant shifts. Because of the issues with placing the implant above and below the muscle the subfacial and intramuscular implant placement techniques have developed and have continued to increase in popularity.

The subfacial technique utilizes the strong covering of the muscle. The fascia is what covers the muscle and is the strongest part of the muscle. The subfacial technique for butt implant placement avoids the problems that can be associated with placement of the implant below the muscle. It also is a much more secure pocket than can be achieved when placing the implant in the typical plane above the muscle. This strong covering will decrease the risk of the implant shifting over time. The fascia is strong and will help soften the edges of the implant.

The intramuscular technique like the subfacial method was developed to help with the issues associated with other methods of butt implant placement. The idea is that it avoids the nerves and other structures that are found in the submuscular position, while giving some buffer to the implant by splitting the muscle. The issue with the intra-muscular placement is that the muscle is typically thinner than people expect which leaves very little muscle below and above the implant. Also unlike the subfacial technique the intra-muscular placement is not a natural plane so there is an artificial division of the muscle. This can damage the muscle and lead to more pain post-operative. If the nerves in the muscle are damaged the muscle can lose some of its strength overtime.

There is no one absolute way to perform a butt augmentation with implants. It is important to discuss the procedure with you board certified plastic surgeon that performs a high volume of butt augmentations.

Austin Plastic Surgeon
4.9 out of 5 stars 123 reviews


A lot depends on how much soft tissue coverage (how much buttock fat you have) over the buttock implants. If sufficient the subfascial plane is less painful and has  a quicker recovery time. Most important is selecting your plastic surgeon wisely. See the below link for helpful hints. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Buttock Augmentation

I have done over 300 buttock implants.  I would actually suggest sub facial placement for you.  I think that you will still have a natural, long lasting result.  Based on the photo you have provided as your "wish pic"  You will need a relatively large implant for your body type.  I would most likely use AART style 3 size 2 with subfacial plascement.  You shouldnt be able to see the implant as long as   you are choosing a board certified plastic surgeon with extensive experience with buttock implants.  

Douglas M. Senderoff, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 32 reviews

Buttock implants positioning

Buttock implant should always be placed under or within the gluteus maximus muscle (aka subgluteal), NOT "subfascial" as this is no different than subcutaneous or "on top of the muscle" and will assuredly result in visibility and easy palpability of the implant. In the subgluteal position, the implant is less palpable, less visible, and does not sag or shift/migrate over time unlike implants placed on top of the muscle. Also, I have many competive bikini and fitness models as patients whom seem to do just fine working out and performing squats post-operatively. Glad to help. 

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 118 reviews


The best longevity and least chance of I implant movement is achieved with implant placment within the muscle. Fat grafting can be a very useful additional procedure to help fine tune the shape and camouflage the implant. 

Nicholas A. Flugstad, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 8 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.