American Society of Plastic Surgeons
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Ms Jane
one year ago
Answered

Breast Revision Recovery for body builder

Not a question, but asking you to post: I had submuscular implants in 2009 and began body building in 2014. By 2016, I had severe distortion in my pec area. After a revision in 2018, I was cleared for workouts after 8 weeks; same result. After a successful, beautiful revision in January, my PS stated I should never be doing pec work again. I wish my surgeon had warned me. Please share!

Procedure: Breast Augmentation
Type: Question

Replies 6

John Lomax
ASPS Surgeon

Over the past several years I have operated on multiple body builders. These have included major national and international competitors. Body builders present a unique patient group. Due to the motion deformity which occurs when the pectoral is muscle contracted, I will not perform augmentations behind the muscle for body builders. Retro muscular implants are favored by all of my other patients. Your unique situation is uncommon. A board certified plastic surgeon and ASPS member experienced with this patient group may be able to your questions better

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Rahul Vemula
ASPS Surgeon
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Thank you very much for sharing your experience. I’m sorry to hear that you have been having so much trouble. You may want to consider switching the location of your implants to above the muscle. However, be aware that if the implant is switched to above the muscle and you do not have enough breast tissue to cover the implant, it may be visible. Please meet with an ASPS surgeon to Learn about all of your options for revision breast surgery

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Debra Johnson
ASPS Surgeon
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Body builders present unique difficulties in breast augmentation. Subpectoral augmentation often results in muscular distortion of the breast. Subglandular augmentation runs a higher risk of capsular contracture (a tight scar with firmness) causing an abnormal appearance. Body builders are usually low body fat folks, so there is little subcutaneous fat to camouflage ripples in subglandular breast implants. You rarely have enough fat to consider fat transfer to mitigate the rippling or add more camouflage. Tough situation. Some surgeons have tried to overcome some of these difficulties by using the more highly cohesive implants to reduce rippling, or consideration of a dual-plane technique to reduce the animation deformity. As plastic surgeons, we need to be cognizant of the unique problems encountered in groups such as body builders. Thank you for sharing your story.

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Curtis Wong
ASPS Surgeon

Ms Jane, I share you sentiments completely and have always advised my submuscular augmentation patients that they are not to strengthen their chest muscles post-op (toning is okay) as I appreciated a major implant malposition in a patient who returned to serious body building where the implants were pushed down and out. This is routinely reviewed with my patients as they return to the lives of their choosing. I do appreciate how many surgeons in their on-line posts, will lift all restrictions on their submuscular patients but it just takes one occurrence to help you realize that you should always avoid strengthening the chest muscles. I appreciate your experience and for your attempt to educate the masses of surgeons who do not realize this phenomenon.

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Nelson Castillo

Thank you for sharing your question. Unfortunately the only way to truly avoid all muscle distortion when lifting or posing is to convert your implants from their current position below your muscle to above. Hope this helps.

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Thomas Fiala
ASPS Surgeon
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This is a well-known situation for most plastic surgeons, known as a dynamic flexion deformity. Putting the implant over the muscle fixes this problem, but increases the issues & risks for other problems: hardness (capsular contracture) and implant visibility and ripples, particular for women who diet down to a very low body fat percentage for competitions. I always ask active body builders what implant position they would prefer, after explaining these choices.

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