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Do You Lose 50 Cc's with Behind the Muscle Silicone Implant Placement?

asked 3 years ago by ADW in Kansas City, mo
Latest answer by Tom J. Pousti, MD
Question viewed 41,758 times
Tags: silicone implant, under muscle, 350-399cc, B to C cup, below muscle

I am getting silicone breast implants on Friday and am really scared of going too big. I am currently a "B"; I want to be a "C". I have chosen 350cc in hopes they will look like the 300-325 implant I tried at my doctor's office.

34 answers to Do You Lose 50 Cc's with Behind the Muscle Silicone Implant Placement?

+8

Significance of implant size

The difference between 325 and 350cc. is less than10%. However, in general, size of implant is determined less by cc's and more by dimensions. Patients have a hard time understanding this and often get fixated on the cc's. The volume is the result of dimensional analysis, not vice versa. In fact, the volume tells nothing about the implants since a 350cc implant can have different dimensions (i.e. base diameter and projection) and thus produce different-looking breasts. The best way to choose... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+7

Under the muscle implants should be larger than the sizers

One of the most uncertain things for women undergoing brest augmentation is to know what they will look like with a certain volume implants. And, as a surgeon, it can be difficult to understand what a women wants when she say she wants to be a full C cup of a small D cup. The use of sizers during the pre-operative consulations has made this very much more straight forward. We will put our patients in a bra and then place different size implants in the bra to both let the patient know what... more
David B. Reath, MD

Knoxville Plastic Surgeon

plasticsurgeryknoxville.com

+7

Volume does not change, but Visual size does.

The hardest part about performing breast enlargement surgery is getting on the same page as my patients with regard to breast size. Often, there are conflicting points of view that confuse an already nervous patient. There are friends telling the patient that they should not do it at all. There are those at the other extreme telling them to go as big as possible. And in the middle are friends telling them that they should go bigger than the doctor suggests or more specifically the dreaded... more
Robert M. Freund, MD

New York Plastic Surgeon
+6

Breast size with implants over vs. under the muscle

What is important to most women seeking breast augmentation surgery is the end result, not the exact size of the implant. Often, patients are surprised to see before and after photographs and learn that a woman with 250 cc implants may have fuller looking breasts than a woman with 325cc implants. There are many variables to consider when selecting the size of implant: The height and frame of a woman, how much breast tissue she has to start with, whether or not she has had children. Cup size... more
Michael Law, MD

Raleigh-Durham Plastic Surgeon

michaellawmd.com

+6

Implant larger than sizer

Essentially the question is that of: How do I choose the correct implant to get the look I am wanting? This is the most important question when it comes to breast augmentation. In order to better address this question, we need to establish 2 main points: First: Implants do not come in "cup" sizes. They either come prefilled (in case of silicone gel implants) with certain volume or unfilled (in case of saline implants) with a range of fill capacity. In either case, the fluid... more
Christopher Chung, MD

Corona Plastic Surgeon
+6

Silicone versus saline breast implants

I find that choosing to go under the muscle and using a silicone implant both are factors in selecting the proper implant size. Silicone implants are underfilled (except for some newer versions used in Europe), and have different tactile and visual aesthetics than saline implants, which are usually overfilled like a water balloon would be if you were trying to smoothen out its edges. I usually compensate by choosing about 25-50 cc more in a silicone implant than I would for a saline implant... more
Jennifer Walden, MD

Austin Plastic Surgeon
+6

No such thing as too big?

Although there is such an entity as "too big", this is rarely the case in breast augmentation surgery. In fact, the saying "I should have gone bigger" is also becoming a dinosaur. The reasons: 1. American Board of Plastic Surgery plastic surgeons take painstaking efforts to try to size the implants to fit your body characteristics and your wishes. Often we have several preoperative consultations to very accurately determine what implant size is right for you. 2. ... more
Kenneth R. Francis, MD

Manhattan Plastic Surgeon

www.francisnyplasticsurgery.com

+4

How To Choose the Best Implant Size For You!

Good communication between the patient and plastic surgeon is the key to choosing the best size implant for each individual. The surgeon should be willing to work on this for while during the consultation. I allow patients to return for a second shorter consult at no charge if they are concerned about their choice of size. Steps: 1. I look at how large the patient is now, how large she was during pregnancy and breast feeding if applicable, whether she has lost volume... more
David L. Mobley, MD

Sarasota Plastic Surgeon

sarasotaplasticsurgery.com

+4

See your plastic surgeon and adequately discuss your implant placement and size .

Ninety five percent or our patients choose to have their silicone implants placed beneath their chest wall muscle (submuscular, also known as the subpectoral plane) and choose implants in the range of 300 cc’s to 450 cc’s. In this range, we usually advise our patients that the muscle may flatten the implants to a small degree and we usually add about 10% to their total volume. Our patients choose their implant size by placing demo implant sizers in a bra. Most important is for... more
Stephen A. Goldstein, MD

Englewood Plastic Surgeon
+4

Does Size Really Matter?

Many variables affect the final outcome of breast augmentation, but the one that most patients seem fixated on is the "cc's" or implant volume. Patients often compare notes with their friends or family members who have also had breast augmentation, and may feel "slighted" if they receive implants that are smaller than what was placed in their co-worker or cousin. This is like being disappointed after a really wonderful dinner that you didn't eat as much, or the same... more
Athleo Louis Cambre, MD

Los Angeles Plastic Surgeon
+4

What does 350 cc really look like?

To begin with, most Plastic Surgeons will upsize the final implant size because there is a small amount of volume displacement lost when the implant is changed from in front of the breast (as it is when you are sizing) to behind the muscle (the final placement). Because of this and also because of the fact that many patients commonly wish that they would have gone a little bigger, we generally will upsize around 50 cc.   As to your actual choice of implant size, without actually... more
Gregory A. Buford, MD

Denver Plastic Surgeon
+3

Breast Implant Sizing

I agree with many of the surgeons responses in this thread....I have my patients sized in my office after I complete their physical exam and take appropriate measurements (about 10+). They use a sizing bra with silicone implants as sizers....the sizers are in a range governed by my measurements and the patients desired outcome (B,C or D cup). I tell all patients that SUBMUSCULAR implants loose about 10-15% of their volume in this position and to therefore upsize appropriately. I then use more
John Philip Connors III, MD

Atlanta Plastic Surgeon
+3

Implants Look Smaller Under the Muscle

Your question is a good one, but it sounds like you made the right choice! Because the implant drapes differently under the muscle, it will look about 10% smaller than the implant looks when you put it in front of your breast in your bra.  The muscle does flatten the implant somewhat and this creates a sense of the implant looking a bit smaller than it did when you tried it on for size. Going up about 25cc is about right for the size you are choosing. We have been... more
Paul C. Zwiebel, MD

Denver Plastic Surgeon

www.pzwiebel.com

+3

Choosing your breast implant size

Silicone implants placed behind the muscle will generally look about 10-15% smaller than the implant that you may have tried on in your surgeons office.  The implants that you try on are outside your body and therefore appear larger.  Once the implant is place under the muscle during surgery, it is also under your own breast tissue and your chest muscle.  The muscle is tight and pushes the implant back resulting in less projection of the implant.  That is why the... more
Stanley Castor, MD

Tampa Plastic Surgeon

www.DrCastor.com

+3

Breast implants look larger when you try them on

Breasts implants appear larger when you try them on than they do when they are under them muscle.  How much larger you need to choose depends on many individual factors and isn't scientific.  As a rule of thumb, you need to get 10 - 20% larger, some times more depending your breasts.  Seven out of eight women who want a different size after breast augmentation want a larger size.
Daryl K. Hoffman, MD

Los Gatos Plastic Surgeon
+3

This is not the best way to select implant size.

To ADW, Hi. You have already had your surgery, and I hope that everything went great. My answer is addressed to other women who may read this as well. 1) The surgeon must know the look you want. Show her or him a picture of what you consider ideal breasts. The surgeon must agree that this is a reasonable look for your anatomy. In general, don't go too big. Large breasts don't age well, and very large implants have more complications and look fake. 2) Then there is a simple maneuver... more
George J. Beraka, MD

Manhattan Plastic Surgeon
+3

Implants appear smaller once placed under the muscle

It is true that implants appear smaller once they are placed in surgery compared to the sizers you try in the office. Below the muscle placement will appear smaller than above the muscle. The difference is likely going to be around 10% so with the implants you are choosing it will be about 30cc. Remember that is barely noticeable, however. Review your sizing with your surgeon. There are measurements to consider that are specific to the diameter of your chest, skin coverage, looseness of your... more
Bahram Ghaderi, MD

Chicago Plastic Surgeon
+3

As long as the implant has a good dimensional fit for...

As long as the implant has a good dimensional fit for your body and as long as it isn't too high in profile, it won't look too big for you. The difference in diameter between 300, 325, and 350 cc implants is less than the width of your baby finger so they are much closer to each other than the sizes might sound to you. You'll probably be just fine with the 350 cc implants after you have adjusted to them and the swelling has settled down.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+3

How to choose a breast implant size?

Placing any breast implant below the muscle will cause the implant to loose a small amount of projection. Though the exact amount isn't quantifiable, your estimation is reasonable. To choose a breast implant, place the implant in your bra. When the implant feels a little too big, you've probably found the right size.
Usha Rajagopal, MD

San Francisco Plastic Surgeon

www.sfcosmeticsurgery.com

+2

Breast implant sizing

The use of sizers in your bra preoperatively does not accurately correlate with the size of breasts achieved with sub muscular implants. I think that it is very important that you communicate clearly with your surgeon to maximize the chances of achieving your desired breast size. 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... more
Tom J. Pousti, MD

San Diego Plastic Surgeon
+2

Breast Implant Sizing

Selecting the size of your implant can be  very thought provoking. I find the best way to help my patients with this is to have them try on the implant.  This allows them to better  understand what the implant will look like on them.  When the implant is placed behind the muscle. it will look about 10% smaller, or about the way the next size down implant looks.   There are many factors that are used in implant selection, and volume is just one of them. ... more
Beverly Friedlander, MD

Short Hills Plastic Surgeon
+2

Estimating breast implant size in the office

Overcorrection of the implants that you tried in the office is a good idea.  Take into account the volume difference of the bra that you used as well. 
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+2

You do look a little smaller with the implants insided.

It is less reliable to say whether the implants look "more smaller" if they are under the muscle vs. on top.  Go with a size that makes you feel like "these are just about too big."  That way, once you recover and your implants drop, you'll have a size more like what you see during your sizing process.
Brian K. Brzowski, MD

Salt Lake City Plastic Surgeon

www.brzowski.com

+2

Breast implant volume estimates

I think your assessment is a fairly reasonable one.  I usually have my patients try on a breast implant in a non-padded bra.  The look that is achieved in this way is about 15% larger than after implanted.  Thus, your 350 cc implant will look more like a 300 cc one.  Remember, one of the most common complaints following breast augmentation: "I wish I had went bigger." Definitely, submuscular placement has clear benefits over subglandular.  Good... more
Jason R. Hess, MD

San Diego Plastic Surgeon
+2

Add 10-15% to sizers if placing implants under the muscle

The general rule of thumb is that whenever you use a sizer placed externally to estimate the desired implant volume, use a similar sized implant if it is ti be placed subglandular and 10-15% if placed submuscular. ESTIMATE OF IMPLANT VOLUME SUBGLANDULAR IMPLANT Implant volume = Sizer volume SUBMUSCULAR IMPLANT Implant volume = 110-115% Sizer volume
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

3D imaging helps

The size of the silicone implant can appear smaller when placed under the muscle and breast tissue.  It is important to discuss with your plastic surgeon the size and shape desired with your breast augmentation. The shape of the upper pole breast, cleavage midline, lateral fullness and projection help determine the type of silicone implant to be chosen during the surgery. Recently, the Vectra 3D virtual breast augmentation pictures have significantly helped predict patient... more
Andrew Turk, MD

Naples Plastic Surgeon
+1

Choosing your breast implant size

It is virtually impossible to choose an implant size and predict how exactly it will look on you.  But we can estimate pretty well what the final result will be. To predict what you will look like you have the option of using sizers (sample implants that you place inside your bra) or sophisticated 3D scanners that scan you and then are able to simulate what you would look like with an implant.  What you need to consider is that once an implant is placed in your body, it... more
Martin Jugenburg, MD

Toronto Plastic Surgeon

www.torontosurgery.ca

+1

Allow your plastic surgeon choose the exact size implant that is most appropriate

Allow your plastic surgeon choose the exact size implant that is most appropriate to give you the desired look you hope to achieve. I prefer to have my patients give me an idea of what size they hope to achieve and then based on this factor, plus their current breast volume, their body and breast dimensions and tissue/skin characteristics will determine which implant size will be best for them. I also prefer to bring several sizes of implants to surgery and use temporary sizers to determine... more
Sanjay Grover MD

Orange County Plastic Surgeon
+1

Volume of implants

Selecting the perfect size implant for an augmentation is extremely challenging. 300-325 cc should bring you to a C cup from a B cup. A 350 cc implant should work very nicely for you. It is true that the implant tends to look a little smaller under the muscle. This is because the muscle flattens it a little bit. It's not that the volume is going anywhere, it's just that the implant is covered a little more. The difference is minimal. The important thing to remember is not to focus on any one... more
John Diaz, MD

Beverly Hills Plastic Surgeon
+1

Implant volume loss

A augmentation patient does not lose volume when placed behind the muscle.  The implant is a closed system, volume goes neither in or out. The breast will change over the first few months as the pec muscle stretches, in it's shape.  The sizes you have chosen seems very reasonable.  Good Luck.
Rodger Wade Pielet, MD

Chicago Plastic Surgeon
+1

This is a very common question. The answer, it depends...

The answer to this question is that it depends on numerous factors. In you particular case, however, it is much easier to get a feel for your desired implant size because you have had a double mastectomy. Therefore, with the breast tissue being gone, the implant is going to make up the new breast. external sizers in the office should give you an excellent feel for the "right" size implant. In addition, you will probably undergo tissue expansion which will be another opportunity to... more
W. Tracy Hankins, MD

Las Vegas Plastic Surgeon
+1

The difference is closer to 25 cc's

I have patients try on sizers as one of a few methods to help determine breast implant size. Outside of the breast, the implant is more prominent than it is internally after implantation. I tell patients the difference is about 25 cc's. I think 50 cc's is a little too high.
York Jay Yates, MD

Salt Lake City Plastic Surgeon
+1

The implants may look smaller when put "Under the Muscle"

Hello, Implants tend to look more natural and have fewer problems over the long term when placed under the muscles though. Just have a good discusion with your surgeon about where you'd like to end up so he/she can do that which is possible to get you there. Best Regards, John Di Saia MD
John P. Di Saia, MD

Orange Plastic Surgeon
+1

Volume is the same

The volume is obviously the same, but as the breast settle into their pocket, the implant may appear somewhat smaller than the size you initially thought you had immediately after surgery.
Steven Wallach, MD

Manhattan Plastic Surgeon

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