Are you a female bodybuilder considering breast augmentation? Here are key tips from Dr. Parker.

One very common experience among female bodybuilders and physique athletes is a dramatic reduction in breast size. This is because fat is a major component of the breasts. With focused training, breasts will “lean out” along with the rest of the body.

This can be a welcome change for some women. It’s easier to find supportive sports bras, and having smaller breasts can make it easier to notice progress in muscle development. For others, a reduction in breast size can be a source of self-consciousness. One option for addressing the issue is breast augmentation surgery.

Having been in practice for over 25 years as a board certified plastic surgeon, I have performed thousands of breast augmentations and can confirm that female bodybuilders have singular needs when it comes to the procedure. If this is something you want to do, you’ll likely need a more specialized approach and choose different implants than the average patient. Most importantly, you’ll want a surgeon that fully understands the nuances of your highly-developed musculature, your workout routine, and finally, the look you want to achieve for competitions.

Read on for valuable tips that will help you make educated choices.

Which plastic surgeon to choose

Limiting your search to plastic surgeons who are board certified by the American Board of Plastic Surgery (ABPS) is a good start. This assures you that the surgeon you choose is residency trained in plastic surgery and has passed rigorous exams confirming their knowledge, skills, and ability to perform plastic surgery safely and effectively. ABPS surgeons also operate exclusively in accredited operating facilities, which is critical to your safety.

Additionally, you will want to your plastic surgeon to have considerable experience performing cosmetic breast surgery, and specific experience with breast augmentation for bodybuilders. This is important because the procedure approach—and what it means to have a great result—can be radically different for a bodybuilder compared to a non-athlete.

As you search for surgeons in your area, look at their before and after photos, paying attention to patients with body types similar to yours and seeing if their results appeal to you. Read patient reviews, and if possible, talk to other female bodybuilders who have had breast augmentation and are happy with their results to find out what plastic surgeon they used.

This will help you narrow down your choices. At your consultation, ask as many questions as you need to confirm the surgeon’s experience and to gauge whether or not you feel like they understand your goals and can deliver the results you desire.

What implant size to choose

One mark of an excellent breast augmentation result for any patient is proportion. The goal is to achieve a balanced look between the upper and lower body—and with very lean patients, this is often accomplished with smaller-than-average breast implants. Additionally, as a bodybuilder, you will likely have less natural tissue to cover the implant than a non-athlete. Choosing a more conservative implant size will help you avoid issues such as rippling and visible implant edges.

Of course, what “smaller” means is different for every patient. An experienced plastic surgeon can help you choose the appropriate breast implant size, shape, and profile to best fit your body and provide the most natural result possible.

It is important to understand that if you are extremely lean, it is possible that breast implants will be somewhat visible or palpable (able to be felt through the skin) even after an expertly performed surgery. For many women, this is not a problem—they like the way their breasts look and feel more confident having implants. Only you know if this is an acceptable possibility.
Over the muscle vs. under the muscle implant placement
Breast implants can be placed directly under the breast tissue and over the pectoral muscles—or a plastic surgeon can release the lower attachment of the pectoralis major and place the breast implant beneath the muscle and breast tissue. There are pros and cons to both options, as well as variations to consider.

Subglandular placement
Over the muscle, or subglandular, implant placement is a popular choice for bodybuilders as the muscle is not affected during surgery. Benefits include a shorter recovery and earlier final results, as the implants will settle more quickly. However, without the additional coverage of the pectoral muscle, the implants are much easier to see and feel under the skin, particularly in lean patients.

Submuscular placement
Under the muscle, or submuscular, implant placement requires more recovery time, as the muscle and breast tissue need to adjust to the implant. However, from an aesthetic standpoint, this is usually the superior option. The muscle provides excellent implant coverage and a more natural breast appearance, and there is a lower risk of capsular contracture (unnatural hardening of scar tissue around the implant) with submuscular placement.

One thing bodybuilders are often concerned about with submuscular placement is how releasing the pectoralis major muscle might affect their chest strength, and whether the implant will be visible when flexing the pecs during competition. When performed correctly, any reduction in muscle strength is usually temporary, and can be quickly regained once a patient is permitted to resume chest exercises.

However, a visible change in breast shape during flexion is a legitimate concern. Flexing the chest muscle can momentarily flatten the implant, which likely will be noticeable during competition when you are wearing a bikini top. If you compete in the Bodybuilding division or are a power lifter, there is a risk that your pecs could get so strong as to permanently displace the implant. In this case, over the muscle (subglandular) placement is typically a better choice.

Dual plane placement
Also worth mentioning is dual plane placement, a variation of submuscular implant placement. Traditional submuscular placement, where the muscle is released from the chest wall only, is equivalent to dual plane I. Dual plane II and III are modified submuscular techniques in which the pectoral muscle is released from the overlying breast tissue as well as from the chest wall. This allows the muscle and implant to slightly “slide” upwards, which in turn mildly lifts the breast. (Here is a helpful diagram comparing these variations on implant positioning.)

While perhaps not ideal for power lifters for reasons stated above, dual plane placement can be a good option to address mild breast sagging without breast lift incisions. Patients who compete in Figure or Fit Body classes can be good candidates for this type of augmentation.

Recovery and time away from workouts
Although downtime after breast augmentation is typically short, it’s important to allow yourself the time you need to recover and heal. Most of my patients return to desk jobs and daily activities such as driving, light cleaning, shopping, and socializing within 4 to 7 days. However, you will have to stay out of the gym completely for 2 to 3 weeks after breast augmentation, and upper body exercises (e.g., pushups, flies, bench press, etc.) are off-limits for up to 6 weeks.

You also will not want to undergo surgery while during a pre-competition dieting phase. For a safe, smooth recovery, your body needs to be able to devote a large amount of energy to healing, and calorie restriction can hinder the process.

A common strategy for my bodybuilder patients is to book surgery a month or two after their last competition for the season. This gives them time to resume a normal, healthy diet and to undergo surgery when their body is closer to its “baseline” appearance. Remember that your breast implants will likely be a part of you long after your competition days are over, so you want them to look and feel good when you’re not competing as well as when you are.

I hope you feel better equipped to make a decision about breast augmentation after reading these points. I will leave you with one more tip. Breast augmentation is a 100% personal decision. Don’t let anyone sway your decision one way or another. If you have any questions, I invite you to contact me at The Parker Center for Plastic Surgery in Paramus, NJ.

About the Author:
Board certified plastic surgeon Paul M. Parker, MD, FACS, specializes in breast, body and facial cosmetic surgery for men and women as well as reconstructive skin cancer treatment as medical director of the Parker Center for Plastic Surgery, which he founded in 1985. The Parker Center also houses the Parker Center Medi-Spa, a full-service medical spa, and is located at 122 East Ridgewood Ave., Paramus, NJ, 07652. 201-967-1212. For more information, visit or read Dr. Parker’s reviews.