Breast Augmentation in Athletic Patients
Dr. Law’s Philosophy on Breast Implant Position for Body Building, Fitness and Figure Competition
I regularly perform breast augmentation surgery for patients who participate in body building, fitness and figure competitions. While many are initially concerned about subpectoral placement and the potential for distortion of the appearance of augmented breasts when the pec major muscles contract, I am absolutely confident that the aesthetic outcome for these patients will be far superior with implants placed in a subpectoral position.
A pre-pectoral (aka submammary) implant in a slender patient, especially one with well-developed muscles, looks just as you imagine it would: like a foreign object, not like a natural-appearing breast. The pectoralis major muscles do not have to contract for a pre-pectoral implant to look unnatural in this group of patients – they look unnatural every minute of the day.
Achieving the ideal aesthetic position for a subpectoral implant requires release of the entire inferior origin of the muscle from the ribs behind the breast. The anatomy of the pectoralis major muscle origin is variable from patient to patient, so meticulous dissection and muscle release is critical for success. I perform the minimal release of the origin of the pec majors that is required to place the implants in an ideal position vertically, and to avoid implant animation or distortion when the muscle contracts.
As a result of this meticulous release of the inferior origin and a portion of the medial origin of the pec major muscles, the vast majority of patients have no distortion of their breast appearance when the pec major muscles are tensed. It is important to understand that ‘subpectoral’ really means ‘partial subpectoral’ as the pec major muscles cover only the upper half of the implants following inferior origin release. The lower half of the implants are submammary, and this allows the implants to create that aesthetically ideal lower pole fullness.
We have not had a single fitness or figure competition patient report loss of function, strength or range of motion from pec major release and subpectoral implant placement. All of these patients have indicated that their fuller but still very natural breast appearance has provided a significant advantage for them in competitions. If you are a body builder or a fitness / figure competitor, make sure that your plastic surgeon can show you appealing ‘before and after’ photos of patients with needs that are similar to yours.