Do the implants lose 50cc when placed under the muscles?

Hello there This was once thought to be the case but recent research has shown just the opposite .Implants - especially larger implants - exert a pressure effect on the breast . Over time this can thin the breast tissue and reduce breast volume .Placement behind the muscle partially protects the breast tissue from this . So implants placed behidn the muscle will actually result in a larger breast than implants in front of the muscle .CheersTS

It is true that an implant looks a tad smaller under the muscle compared to a pre-op sizer in a bra.  Having help patients size hundreds of times, I have concluded that the 'smash' of a snug sports bra nearly equals that loss. They 'cancel' each other out!  So that makes it easy:  fit with a snug sports bra and find the closest volume that you desire.  No complicated math formulas needed!  

Thank you for your question.
I have heard this question many times before from my patient when trying implants or sizer in the bra.
My answer is usually that how they will look in real life is going to be different from how they look in the bra and is not possible to determine if they will look bigger or smaller before surgery 
Definetely I would not recommend to choose a bigger implant only because is going to be placed under the muscle.
Regards
Mr Netri

There are number of ways surgeons will try to convey a sense of post augmentation size in the pre-operative period. These include 3D imaging and sizers. While helpful, they are not perfect.
The use of sizers can help give a sense of volume increase when placed in a bra. However, placement underneath tissue will alter the shape. While there is no exact way in which to quantify this shape change, patients should be aware that there is a change in projection when placing an implant underneath the muscle which is difficult to predict. I have heard a number of theories ranging from a % drop in projection to a purported volume drop. These are not scientific correlates with no consistency. I have not found these to be helpful.
Patients should be aware that how they appear in a garment is not exactly how they will appear post operatively. 3D imaging is helpful in accounting for this variation. Ultimately, at the end of the day, this remains a computer simulation.
Ultimately, even if submuscular placement did account for a perceived volume loss, 25-50 cc is a subtle change and equates to the volume of a shot glass (at most). 
Implant selection is a process which should involve both the physician and the patient, using good communication to take full advantage of patient goals and surgeon's experience.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

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 helps. Best wishes.

Thank you for your question. Because of the added soft tissue coverage, the overall volume when an implant is placed behind the muscle can seem smaller - because the pocket is tighter, and the implant can slightly change shape. If someone likes how they look with a 300cc implant (in a bra), then I will typically go up 30-40 cc when placing the implant. I also use VECTRA, which is a 3-d imaging system that helps to take a little bit of the guess work out of implant selection. Simulations tend to give a more accurate assessment of volume, and of your "final" size. Hope this is helpful! Best of luck!