By Lisa Guggisberg
They come in all shapes, sizes, saggy, perky, and flat. If you are a female mammal you have them. I’m talking about breast, boobs, tatas, melons, tits, jugs….whatever you call them, if you’re female you have them. Some women are happy with their factory setting breasts and others like to upgrade their packages. I fall into the later category. Yup! Let’s just get that out there – I have breast implants. My secret is out (insert sarcasm here). I have had implants for over 13 years and recently had them redone. When I considered having them redone, I decided to do a little research and was shocked to find there is little to no valuable information on breast implants for powerlifters, or women who train chest and bench heavy, let alone for women who bench in shirts. There is some information out there for figure competitors choosing implants, but they tend to train their chest much less than a powerlifter does.
So here’s the deal, I know there are a lot of women out there that have a lot of questions regarding lifting heavy and having breast implants, so I decided to do my own research and share my experience. Hopefully this will answer some of those questions for my fellow ladies looking to upgrade their package.
When I got my first set of implants, I did not powerlift, in fact I hadn’t even set foot in a gym before. This was 13 years ago. I did my research on local plastic surgeons, asked for opinions and found a surgeon I was comfortable with. They had experience, good credentials and came highly recommended. At the time I weighed about 95lbs. I was “skinny fat” and carried little to no muscle. I ended up getting my implants placed under the muscle.
What does under the muscle placement mean? Well, there are several ways a surgeon places the implants. Two of the most common implant placements are: under the muscle and sub-glandular, often referred to as over the muscle.
Under the muscle
Sub-muscular, or under the muscle placement, is a technique where the implants are placed partially under the pectoralis major chest muscle.
- A more natural look, as the implants are covered by both the breast tissue and the pectoral muscle.
- Reduced risk of visible rippling.
- The muscle supports the placement of the implant reducing the wear to the skin.
- Reduced risk of capsular contracture development.
- Less distortion of mammograms.
- Decreased risk of the implant “bottoming out”.
- Surgery can be more “invasive.” The surgeon will separate and dissect the chest muscles to fit the implant in and sometimes cut the muscle so that the implant will sit right.
- Longer recovery time mainly due to more post-op pain/discomfort.
- Breasts may appear to sit a bit high until the muscle fully relaxes, or drops and fluffs (about 4-6 weeks post surgery).
- Implants can become distorted when the chest muscle is flexed.
Sub-glandular (over the muscle)
Sub-glandular placement puts the implant between the breast tissue and the chest muscle. Over simply over your chest muscles.
- Surgery is less invasive. Not dissecting, or cutting of the chest muscles.
- Shorter recovery time and less post-operative pain, as your muscles are not stretched, cut, or dissected.
- Possibly more cleavage can be created because the implants can be placed slightly closer together.
- Larger implants can be utilized depending on how much natural breast tissue you already have.
- Implants do not become distorted when the chest muscles are flexed.
- Less natural looking (con if you don’t like an augmented look, pro if you prefer an augmented look).
- Higher chance of visible rippling as there is less tissue covering the implant.
- Creates more mammogram distortion which requires more views to be taken.
- The rates of capsule contracture are higher.
- Increased risk of the implant “bottoming out”.
Since, at the time, I wanted a more natural look, I decided to go under the muscle. Flash forward to present day and this eventually became a problem for me, but I’ll get to that later.
At the time I had my first surgery, the new silicone implants had just come out and were not approved for everyone. Only breast cancer patients wanting reconstructive surgery and women who had previously had breast implants were able to get them at the time. Now, there are three types of implants available to everyone: saline, silicone and the newest cohesive gel or “gummy bear” implants.
Saline implants are filled with sterile salt water. They’re inserted empty, and then filled once they’re in place.
- In the event of a leak, the saline inside the implant will leak out and be harmlessly absorbed by the body.
- Saline implants are initially empty and are filled after they are implanted. This requires a much smaller incision, resulting is less scarring.
- Because saline implants are “custom filled,” they’re ideal for women with uneven sized breast. The implant comes as an empty shell and the surgeon will fill the implant with the desired amount of saline once placed inside.
- Saline implants are half the price of silicone
- If your implant leaks a saline implant will quickly deflate, visibly changing the appearance of the breast.
- Saline implants have higher risk of capsular contraction, or visible rippling.
- Saline implants are firmer and feel less like natural
- Saline implants have a higher risk of leaking.
Silicone breast implants have an outer silicone shell and are filled with a thick medical-grade silicone gel.
- Silicone gel implants are softer and feel more like real breasts.
- Recommended for women who are very thin, or have little natural breast tissue to cover the implants.
- Risk of leakage is lower compared to first generation silicone implants, or saline implants.
- A leaking silicone implant will not collapse like a saline implant.
- If implant rupture occurs silicone gel is not safe in the body.
- Silicone implants are inserted pre-filled, which requires a larger incision.
- Twice the price of saline implants.
- Pre-filled so difficult to size if you have uneven breasts.
Cohesive gel or “gummy bear”
Gummy bear implants earned their nickname because they are made of a cohesive gel material that holds its shape even when cut, much like the tasty candy. This stability is achieved through the use of a dense silicone gel.
- More natural look and feel than original silicone implants
- Less likely to fold or leak.
- If rupture or leak does occur the gel does not move throughout your body. Think of cutting a gummy bear open, noting oozes out!
- Less likely to have capsular contraction.
- Less likely to have visible rippling.
- Stays more in place when laying on your back.
- Most expensive implant on the market.
- Larger incision needed to fit implant in.
- Pre-filled so difficult to size if you have uneven breast.
There are several manufactures that are approved for use in the US and each of those manufactures have several different styles; high profile, moderate profile, anatomical, round, low profile. I won’t get into all those different types as this is something you and your plastic surgeon should discuss. Tell him what your expectations are with regards to size, appearance and he will, based upon your body type and shape, recommend what he thinks is best to achieve your desired look. You pay them for their expertise, so let the doctor be the doctor and chose what he thinks will work best for you. Let them know your activity level. If you can, find a surgeon that specializes, or works with female bodybuilders, or athletes. Bring in example pictures of your desired look to show your surgeon so they have a clearer idea of what you want. Just don’t get so caught up on having the exact look of your “wish” look. You gotta understand the surgeon is not God and can only work with what he has i.e. your natural shape and body type.
I was initially very happy with my original implants. They fit my body and were the right size for me. I started weight training and then eventually got into CrossFit and never had any issues with my implants. I could do burpees, pull-ups, muscle ups, push-ups, etc. I was never afraid of breaking or “popping” an implant. Even when I started powerlifting I never had a fear that dumping a loaded bar on my chest would cause a rupture. Implants are more durable than you think. Check out this video if you want to see just how durable they are.
I never had any issues with my implants until I started powerlifting and started adding a lot of muscle, specifically to my chest. Over time, my chest muscle had caused my implants to become laterally displaced and eventually caused them to “bottom out.” This means my implant had moved out from underneath the muscle and were poking out at the bottom of my pec. My chest muscles had caused my implants to move out towards my arm pits and had pushed them down. If you looked at me in a bathing suit top you would never guessed I had implants because I was completely flat on the top area of my chest. Also, as I mentioned before, I was a skinny 95lbs when I got my first set of implants. I now walk around at 120-125lbs on average and my body composition had changed. My back was wider and my old implants just didn’t look right on me anymore. In addition, when I trained my chest I could feel my implants moving. I knew I would have them redone eventually, as I hated them. When I flexed I could feel the implant move and you could see it move. It was not attractive. Had I foreseen I would be powerlifting competitively, I would have gone with an over the muscle placement in the first place. Another reason I decided on a revision is due to the fact that implants have a typical “shelf life” of 10-15 years. Anything over that and your chances of a rupture increases as the shell of the implant will start to wear and weaken. I actually had a slow leak in one of my implants unknown to myself or the surgeon until he removed my old implants and did a water test to confirm the cc volume.
When I did decide to have them redone, I made sure I had planned a long offseason. I wanted to have plenty of time to recover from the surgery and not mess with any work the surgeon had done. It’s one thing to recover from surgery when your health insurance pays the bill, but another when you pay out of pocket – you want to protect that investment!
I went back to my original surgeon, as I trusted him and loved his original work. On my initial consult we talked for over an hour about several options he could do for me. The question was, “do I go over the muscle or stay with my current placement of under the muscle?” My surgeon said that with women who lift weights, there really is no right, or clear choice. Over the muscle, or under the muscle each had their pros and cons. With the over the muscle placement and the lower body fat on my chest area, there was the chance of a less natural look and possible rippling. Staying with under the muscle might result putting me back in the same spot I was in, with displaced implants. He gave me a few websites to check out and told me to take some time to think about my options.
Under the muscle risks:
If I continued to powerlift, I would have the likely chance the muscles would laterally displace the implants and they would bottom out again. I was NOT giving up powerlifting.
Under the muscle benefits:
More natural looking, less likelihood of rippling (which is where you can see the edges of the implant through your skin) less likelihood of capsular contraction (which is where a hard scar tissue builds up over the implant creating a capsule around the implant. This causes the breast to become hard and deformed) and for me, since I had already had implants, less recovery time.
Over the muscle risks:
Chance of rippling or capsular contraction and a less natural look. I would have a longer recovery time, as he would have to internally suture and reattach my pec muscles from where he originally dissected them and my current implants had made the “pocket,” or the area where my implants rested larger. He would have to go in, make the pocket smaller and tighten the muscles.
Over the muscle benefits:
Implants would not become displaced and I could continue to train my chest muscles.
He did highly recommend that if I choose to go over the muscle that I select the new cohesive gel or gummy bear implants, as they currently have the lowest risk of capsular contraction and rippling.
I weighed the options, knowing that I wasn’t happy with my current implants and that giving up powerlifting wasn’t an option, I decided on an over the muscle placement with the new cohesive gel implant.
Surgery and Recovery
Surgery was a breeze. I was down for about two days, but by the third day was completely off pain meds and moving around. I know pain tolerance is different for everyone, but the second time around for me was so much easier than the first. My incisions looked great and I hardly notice them. The second time around is always easier though. My initial surgery I was out for an entire week. I remember the pain from the stretching of my muscles to place the implant under them caused me to feel like I had an elephant sitting on my chest and I was unable to move my arms. I stayed on the prescribed pain meds the entire week. I was in a sports bra for 8 weeks and it took about that long for the implants to finally drop into place from where they were, which was pretty much sitting on my collar bone. I wasn’t able to do any overhead movements, open doors, or jars, and anything outside of my minimal range of motion was difficult for the first 3 weeks. Of course this eventually resolved. Like I said, once I healed, activity level with the implants was no issue. At the time I started CrossFit and never had any problems.
After my revision, I was advised to avoid any overhead movements for two weeks and no lifting until the surgeon cleared me. Three days after surgery, I did go to the gym and walked on the treadmill, which the surgeon said was perfectly fine as long as I didn’t sweat on my incisions.
A week after surgery I continued to walk 30 minutes daily.
At two weeks, I started light lower body workouts. I didn’t use any weights, but did a lot of bodyweight movements.
At three weeks, I started to add in weights to my lower body workouts.
At four weeks, I did light barbell squats.
At five weeks, I am just now starting to add in upper body movements with bands and light weights. If something hurts or feels off, I stop.
I have not been able to bench, do pull ups or dips yet, as those still cause some pain. I am now able to squat and deadlift up to 80-85% of my best and do all lower body movements without any pain. Most importantly, if something hurts I immediately stop.
I wasn’t worried about losing any strength during recovery and actually looked at it as a time to take a much needed deload, rest and reset my body.
I have not even thought about putting on a bench shirt yet. More to come on that, as I am not quite sure what to expect when I do put the shirt back on.
If you do decide to make the leap and get yourself some new assets, make sure you do your own research. Talk to your surgeon and make them very aware of your activity level and do what makes you feel good. I tend to live and breathe powerlifting, but at the same time I like having an upgraded package and I am confident that you can be a competitive powerlifter with a nice rack.
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