by Anu Bajaj, M.D
Recently, a patient asked me this question.
The other related question that I’ve also been asked is,
“Can you do a Chaturanga after a breast augmentation?”
The question may be a concern if the implants are placed underneath the pectoralis (or chest) muscle. I remember that as a resident, I would hear many surgeons tell women who have implants placed under the muscle that they will not be able to do push-ups or will never be able to do any chest specific exercises such as a bench press.
In answering this question, I’m going to approach as both a physician and a woman.
The muscle that we are referring to is the pectoralis muscle – the muscle that you use when you do chest presses or push-ups at the gym. Placing an implant under the muscle is known as a “submuscular” placement; placing it on top of the muscle is known as “subglandular” placement (it is under the breast gland).
The advantages of a submuscular placement are a more natural look, possibly less rippling (particularly in thin women), possible improved mammographic visualization (any breast implant will affect the ability of a mammogram to visualize all breast tissue and extra views are generally required), and some studies also suggest a lower rate of capsular contracture.
The major disadvantage of submuscular placement is distortion when activating the chest muscles (when working out). The main advantage with subglandular placement is the absence of muscular distortion; however, the implants may be more visible and have more rippling, particularly in thin women. Because of these differences, some surgeons are concerned that activation of the pectoralis muscle could distort the implant pocket and move the implant; so, some will advise women with submuscular implants to avoid these exercises.
As a woman with submuscular implants, I’m very active – I run, I lift weights, I do yoga. I remember running for the first time after my surgery – I felt as if my breasts were going to fall off and had to hold them to my chest to prevent it. As for push-ups….I think it was a year before I attempted doing push-ups. And the first time that I held a plank, I felt like I was going to collapse. That said, now I can do regular sets of push-ups, I can bench press almost my body weight, and I can do pull-ups. Fortunately, I’m not aware of any significant animation deformity.
Philosophically, as a physician and surgeon, I approach any surgical procedure with two principles. The first is that the vast majority of surgeries I perform are designed to improve quality of life – if the goal is to improve your quality of life, the surgery shouldn’t limit what you do long-term. The second is that your anatomy and lifestyle will impact the size of the implants that are best for you. For example, an implant that is larger than the width of your breast will either go into your armpit or sit very high; similarly excessively large implants will thin the skin and overlying tissues making rippling more of an issue and can also cause pain and discomfort with exercise.
As a result of my own experience, I advise my patients to listen to their bodies. Most women will be able to resume working out 2-3 weeks after surgery; although, I usually tell patients to wait a few months before resuming aggressive chest exercises — and then when they start, it will take time to build up their strength.
But there is no reason that you shouldn’t be able to do the things that you enjoy after surgery.