In short
- You can do sport, any sport. What changes, if the implant sits under the muscle, is that it can deform when you contract the pectoral: this is what is called animation deformity.
- When you go back, in a standard case: sport at one month, and contact sports and diving from 2 months. Individualised according to how you are progressing.
- 🔑 How often it happens. In a series of 40 patients assessed by independent observers: 22.5% with no distortion, 62.5% minimal, 10% moderate and 5% severe.
- And what the patients themselves think: in a questionnaire to the same group, 82% described it as mild or non-existent, and only 1% said they would not recommend the subpectoral position.
- The activities that show it most: weightlifting (24%) and exercising (19%).
- ⚠️ You can and should carry on having mammograms. The implant covers part of the tissue, which is why there is a specific technique of displacement views: all you have to do is say that you have implants when you book the appointment.
- 🔑 The implant check ultrasound does NOT replace screening mammography, or the other way round. They are two tests with two different jobs.
- You can fly, dive and go through security with no special precautions.
- And there is one calendar that is genuinely new: the imaging check-ups on the implant, because most silicone ruptures are silent.
Once recovery is over, most women with implants live exactly the life they did before. There are four things that do change, and this page sets out what is known about each.
None is a problem. All are worth knowing about before surgery, because they are permanent.
Sport and animation deformity
It is the thing most asked about and least explained.
What it is
When the implant is placed under the pectoral muscle, the muscle passes over it. When you contract it — lifting weight, doing a press-up, leaning hard on something — the muscle squeezes and displaces the implant, and the breast deforms momentarily.
At rest it does not show. It appears only with contraction, and disappears when you relax.
⚠️ It does not happen with the implant placed in front of the muscle, and that is one of the real trade-offs of the plane: a meta-analysis found that the subpectoral plane has less capsular contracture and less haematoma, and more implant displacement and more animation deformity than the prepectoral.
How often it happens
There is one series that measured it two ways at once, which is what makes it useful.
Assessed by independent observers, on photographs of 40 consecutive patients operated on in the subpectoral plane:
| Degree of distortion | Patients |
|---|---|
| None | 22.5% |
| Minimal | 62.5% |
| Moderate | 10% |
| Severe | 5% |
And assessed by the patients themselves, in a questionnaire to 195 women with 69 responses:
- 82% described distortion as mild or non-existent.
- 10% moderate and 7% severe.
- The most problematic activities: weightlifting (24%) and exercising (19%).
- 🔑 Only one patient (1%) said she would not recommend the subpectoral position.
The authors’ conclusion has two halves and both deserve quoting: animation deformity is real, and almost all the patients in that study would choose the subpectoral plane again. And they add a useful criterion: the candidates who may be better served by subglandular placement are those for whom exercise is central to daily life.
⚠️ It is a single-surgeon series with a 35% response rate to the questionnaire. Its figures are indicative, not a population rate.
What sport you can do
Anything. Running, swimming, cycling, weights, contact sports, yoga, climbing.
What is worth knowing:
- A good sports bra matters more than it did before, particularly in high-impact activities.
- In sports with direct impact to the chest, the theoretical risk of rupture from trauma exists: the FDA includes trauma and intense physical pressure among the causes of rupture. It is not a reason to stop doing them. And from when. The house timings, for a standard case with no complications:
| Activity | When |
|---|---|
| Walking | From the same day |
| Sport in general, building up gradually | At one month |
| Contact sports and diving | From 2 months |
⚠️ Both timings are for a standard case with no complications, and the surgeon tailors them to how you are progressing. If something has not gone to plan, they are put back — and that is said by the person who has seen you at your check-ups, not by a table.
🔑 Why contact sports and diving go a month beyond the rest: not because they are forbidden — they are not — but because with direct impact and changes in pressure a margin of caution is cheap, and waiting another four weeks costs nothing. It is a conservative recommendation, said as such.
The rest of the calendar is set out in detail in the recovery article.
Mammograms
This is the most important part of this page and the one that generates most misunderstanding.
Yes, and they are just as necessary
Population screening for breast cancer applies to you according to your age and your history, whether or not you have implants. Having implants does not take you out of the programme or replace it with something else.
What changes technically
The implant is radiopaque: on a conventional mammogram it hides part of the breast tissue behind it.
That is why there is a specific technique, the displacement views — also called the Eklund manoeuvre — in which the implant is pushed back and the breast tissue is drawn forward so that it can be seen. The usual approach is four views per breast instead of two.
🔑 The only thing you have to do: say that you have implants when you book the appointment. Not on arrival, when booking — so that the time is set aside and the right views are planned.
And the point most often confused
⚠️ The annual implant check ultrasound does not replace screening mammography, or the other way round.
- The mammogram looks for breast cancer in the glandular tissue. It is the test population screening rests on.
- The check ultrasound monitors the state of the implant and the capsule, and also examines the tissue.
The two complement each other. Ultrasound also detects cancer — in women with dense breasts, adding it to mammography detects between 3 and 5 more tumours per 1,000 examinations, most at an early stage — but that does not make it a substitute for screening.
⚠️ And a technical point from the FDA worth knowing: the calcifications that form around an implant can be mistaken for cancer on a mammogram and lead to additional surgery. It is one more reason for whoever interprets the test to know that you have implants.
Implant check-ups
They exist because rupture is usually silent. The FDA says so: most silicone gel ruptures give no symptoms, do not change the appearance or feel of the implant, and may not be detected by physical examination.
The minimum the FDA sets out: a first imaging test at years 5 to 6 and then every 2 or 3 years, with MRI as the most effective method and ultrasound as an acceptable alternative in patients without symptoms.
ICPM’s standard is tighter: an annual breast ultrasound, which is not carried out at the centre and whose result is reviewed at the follow-up appointment.
All the detail — when an implant is replaced and when it is not — is in its own page.
Travel, planes and security
Three frequent questions with the same answer: nothing happens.
Flying. Implants are not affected by cabin pressure. The myth that they “explode” or deform on a plane has no basis: the cabin is pressurised and the pressure difference an implant is subjected to is negligible compared with what it is designed to withstand.
Airport security. Metal detectors and body scanners do not identify a breast implant as a threat or damage it. There is no need to say anything or carry documentation.
Diving. There is no established contraindication to diving with implants, in the short or the long term. What there is, is a prudent interval after surgery: from 2 months in a standard case, the same as contact sports. If you dive regularly, raise it at the consultation.
MRI scans for other reasons. These can be done with silicone breast implants without any problem; in fact MRI is the reference test for assessing them.
What does not change
It is worth saying because it is reassuring:
- Sensation, in the vast majority of cases, returns to its previous level. It is in its own page.
- The ability to breastfeed: in a series of 4,927 patients, the incidence of breastfeeding problems was similar to that in post-partum women without implants. It is in the page on motherhood.
- Your sex life.
- Sleeping however you like, once recovery is over.
- The ageing of the breast. Your own tissue carries on around the implant: it changes with weight, with pregnancies and with the years.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
When can I go back to the gym after surgery?
At one month, building up gradually, in a standard case with no complications. Contact sports and diving, from 2 months. These are timings the surgeon adjusts according to how you are progressing.
Can I lift weights with implants?
Yes. If the implant is under the muscle, it can deform momentarily when you contract the pectoral. In the series that studied it, weightlifting was the activity that showed it most (24% of patients), and even so only 1% said they would not recommend the subpectoral plane.
What is animation deformity?
The momentary deformation of the breast when the pectoral muscle contracts, where the implant is placed beneath it. At rest it is not apparent. In a series of 40 patients assessed by independent observers, 22.5% did not have it, 62.5% had it minimally, 10% moderately and 5% severely.
Can I have mammograms?
Yes, and you should carry on having them. Specific displacement views are used so that the tissue the implant hides can be seen, usually four per breast instead of two. All you have to do is say that you have implants when you book the appointment.
Does the annual ultrasound replace my mammogram?
No, and it is the most important confusion on this page. The mammogram is the breast cancer screening test; the annual ultrasound monitors the implant and the capsule and also examines the tissue. They complement each other.
Do implants burst on a plane?
No. The cabin is pressurised and the pressure difference is irrelevant to a breast implant. Nor do security checks detect or damage them.
Can I go diving?
There is no established contraindication. If you dive regularly, it is a reasonable conversation to have with your surgeon.
How often do I need a check-up?
The FDA places the first imaging test at years 5 to 6 and every 2 or 3 years thereafter. At ICPM the standard is tighter: an annual breast ultrasound, carried out outside the centre and reviewed at the follow-up appointment.
Sources
- Spear SL, et al. Outcome assessment of breast distortion following submuscular breast augmentation. Aesthetic Plastic Surgery, 2009. PMID 19052809. — Assessment by independent observers of 40 consecutive primary subpectoral augmentation patients: 22.5% with no distortion, 62.5% with minimal distortion, 10% moderate and 5% severe; a questionnaire to 195 patients with 69 responses (35% participation): 82% described distortion as mild or non-existent, 10% moderate and 7% severe; the most problematic activities, weightlifting (24%) and exercising (19%); only one patient (1%) stated that she would not recommend the subpectoral position; the authors note that the candidates best served by subglandular placement are those for whom exercise is central to daily life.
- Li S, et al. Complications Following Subpectoral Versus Prepectoral Breast Augmentation: A Meta-analysis. Aesthetic Plastic Surgery, 2019. PMID 31139912. — Significantly lower rates of capsular contracture and haematoma in the subpectoral group and significantly higher rates of implant displacement and animation deformity; no significant difference in further surgery, seroma, rippling, infection and rupture.
- Risks and Complications of Breast Implants. U.S. Food and Drug Administration, updated 14 December 2023. fda.gov. — The silent nature of most silicone gel ruptures, the impossibility of detecting them by physical examination, MRI as the most effective method and ultrasound as an acceptable alternative in asymptomatic patients; trauma and intense physical pressure among the causes of rupture; calcifications around the implant can be mistaken for cancer on a mammogram and lead to additional surgery.
- Lund HG, et al. Low Risk of Skin and Nipple Sensitivity and Lactation Issues After Primary Breast Augmentation with Form-Stable Silicone Implants: Follow-Up in 4927 Subjects. Aesthetic Surgery Journal, 2016. PMID 27118002. — The incidence of breastfeeding problems was similar to that reported in post-partum women without breast implants.
Book your consultation
If you do strength training regularly, say so at the first consultation: it is one of the few things that can tip the choice of plane. And if you already have implants and are not sure which check-ups are due, that is a short consultation worth not postponing. It is assessed at our practice in Valencia.
Clinical confirmation by the surgeon
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Registration no. 46/4624503
