Is that true that Implant placed under the muscle ends up looking smaller?

Hi and thanks for your question. Every patient is individual, the same implant can look quite dfferent in two similar patients. Speak candidly with your accredited PS who is the best person to advise you on what size implant will achieve the result you want. If in doubt, go with the larger size your ps suggests. I rarely have a patient say they have gone too big, most if anything wish they'd gone slightly larger! Sub-pectoral implants may look a little smaller/smoother. good luck

Implants under the muscle may seem smaller in some women, but not all.  Nonetheless, I always place the milk ant under the muscle.  I don't think you would see much difference between the 375 and 400 implants, but if you are concerned they won't be large enough, go for the 400's.

    It is not unreasonable to increase the size by about 10% due to compressive forces.Kenneth Hughes, MDLos Angeles, CA

you ask a great question. I would tend to agree that an implant under the muscle looks slightly smaller than one on top of the muscle. It also looks more "natural" or rather, less augmented. As for the size, it is best to look at photos of women who have implants under the muscle in order to compare yourself (before surgery) to their preop photos. If you are trying on implants in a bra or shirt to get an idea of the size, I agree that if you like the way 375 cc looks, you may want to go 400 cc to get the same look. Good luck.

The best cosmetic result in
any particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.An implant placed under the muscle will generally look slightly smaller than the trial sizer in front of the breast inside a tight t-shirt or bra.Keep in mind that following
the advice from a surgeon on this or any other website who proposes to tell you
what to do without examining you, physically feeling the tissue, assessing your
desired outcome, taking a full medical history, and discussing the pros and cons
of each operative procedure would not be in your best interest. I would suggest
you find a plastic surgeon certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) that you trust and are comfortable with. You should discuss your
concerns with that surgeon in person.Robert Singer, MD FACSLa Jolla, California

It is true that breast implants placed in a bra over your skin can seem a bit smaller in size when a corresponding implant is actually implanted in the breast pocket.  Your surgeon should review this in detail and take this into account when suggesting a particular implant for you.

 Women seeking to undergo breast augmentation surgery can really confuse themselves if they listen to all the “myths” out there. I would suggest, instead that you communicate your goals very carefully with your plastic surgeon, who you should choose carefully. In my practice, I find the use of goal pictures, in bra sizers, verbal communication in front of a full-length mirror, and computer imaging all very helpful during the communication process.  On the other the hand, references to cup sizes ( such as C or D cup) are not helpful; words such as “natural” or “fake looking” can be confusing as well.  Then, based on careful communication and with the use of intraoperative sizers, I am able to select  the best breast implant size/profile to achieve the patient's goals as closely as possible.  Again, please do not get too hung up on the mythology surrounding breast augmentation surgery. Best wishes. 

The muscle compresses the implant therefore it appears smaller when placed under the muscle so we recommend one size larger than the size chosen by the patient.

Thank you for your question. This is a common and confusing issue among breast augmentation patients.Communicate clearly with your surgeon what your goals are and listen to what she or he has to say about how to reach them.If you are worried about appearing slightly smaller once the implant is under the muscle, go up one size. I hope this was helpful.

Breast implants are measured by volume (cc's) and dimensions (three) but what you're really interested in is the effect, not the number of cc's. The same goes for fitting shoes or dresses. The same size works differently on different bodies and you can't just choose a size (or volume) and make it work. I generally agree with Dr. Pousti's response except I don't find external sizers and computer imaging to be very helpful either. The reason is that an implant has one effect externally, a different effect under the skin/breast, and another under the pectoralis muscle. The implant and it's volume is the same but it has a different effect. Yes, the same volume and dimension implant under the pectoralis muscle will not have as much effect as the same volume and dimension implant under the breast but there are a whole host of reasons why implants do better under the pectoralis muscle for the upper half of the breast. Also, 25 cc's difference is barely noticeable in the result. Implants are properly sized by making sure the width (diameter) of a round implant is about 3/4 to 1cm less the breast it is fitting behind (measured with the body upright and arms down). The only real choice for a properly fitted implant is the forward volume (profile). Generally in breasts that are not too wide or narrow for the chest around, the effect of the lowest profile implant that fits properly behind the breast and below the pectoralis muscle will make the breast look about one cup size bigger than it started (although this is far from exact or measurable). The highest profile implant of the same width will make the breast look about two cup sizes larger, and the middle profile will be in between. The number of cc's is determined by looking up the proper width implant in the chosen profile. It's far from exact but this is the best way to determine the effect in my opinion and experience. Agree on what size the breast is to start with and figure up 1-2 cup sizes depending on the forward profile. Don't start with the number of cc's and work backwards. This also has the advantage that the surgeon knows the implant will fit before the surgery and the patient knows what the effect will be and isn't surprised or disappointed.