How Many CCs are Lost w/ Under Muscle Placement?

There is no loss of cc's wehn a breast implant is placed under the msucle. The implant does not get smaller. But, it may appear smaller than when you tried on the implant in your surgeon's office. This is because the implant settles into position on the inside and always looks slightly smaller than when it is just stuffed in a bra. This is why I usually advise my patients who are stuck deciding between 2 sizes of implants, that they should go with the slightly larger size....it will usually look about 10-20% smaller after surgery.

In general when performing breast augmentation with sizers pre-operatively. We use a final fill for saline implants that is roughly 10-15% larger than the sizer which is tried over the intact breasts if implants are to be placed under the muscle. For silicone we use implants that are 15-20% larger than the sizer.

It isn't necessarily the fact that under muscle subtracts cc's but when you are tucking samples in a bra they look bigger because they are "stacked" on top of your breasts. An allowance is therefore made by going a bit larger to get the same look. Sounds like you are getting good advice.

Thank you for the question. No, in my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.

The use of implant sizers in the office to estimate final implant size is an inexact science. The determination of implant size is based on your breast anatomy, including breast width, skin compliance, and overall breast coverage for the implant. If you are starting as an A cup, I recommend using high profile implants placed under the muscle. This allows for more volume within the implant and adequate coverage of the implant without distorting the breast. Also, because your breast volume will be essentially all implant, silicone gel may be a better option for you due to its more natural feel and lower tendency to ripple. In breast augmentation, the most common complaint is not going big enough with implants, so if you are uncertain on size, I recommend going with the slightly larger implant.

This is not an exact science.when patients put a sizer in their bra and say that's what i want .It doesn't always equate to what they will get from the operating table especially with saline.the advantage with saline is that you can add some saline to the final result.

For years, I have recommended to patients that they DO NOT use implant sizers in their clothing to determine breast size.  This is very inaccurate and often leads to patient disappointment.  How an implant fits in your brassiere is not how it will look in you.  This is because the volume of the implant in a bra is only adding to the projection of the bra, not your body.  What I recommend is that my patients bring in photos breast of what they like and what they dont like. We use the photos as a guide during surgery and we determine what profile and volume is necessary to accomplish this.  We of course cannot guarantee an exact match but this gives us a much more accurate guide and leads to greater patient satisfaction.  

I agree there is no loss of cc's under muscle placement. But the number one compliant is "I wish I would have gone bigger!" So I recommend 300cc HP implants . Best of luck from MIAMI DR. Darryl j. Blinski

You do not really lose cc's when the implants are placed inside.  But when they are placed for sizing purposes in a bra they are falsely pushed out a bit.

Generally, it is difficult for patients to notice differences that small whether above or below the muscle.