Is the Difference Between 350 Over Muscle and 420 Under Muscle Sizable?

5foot8 and 68 kilos

Doctor Answers 7

How to pick breast implants.

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How to pick breast implant sizes

1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating room inventory, and put in your breasts to complete the operation.

Manhattan Plastic Surgeon

Implant choices

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A 70 cc difference in implant volume is not large but a discussion on the choice of implants for you is something that you should review carefully with your doctor.  This is done after a thorough exam and a review of your desires in terms of size.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Go Under the Muscle and decrease your risk of capsile contracture.

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Pick your size and go with it.  In 3 monthe the breasts look the same regardless of under or over the muscle.  Go under the muscle and reduce your risk of a capsule and firness.  Firness is still a significant problem so why even consider over the muscle.  Seek 3 opinions from ABPS FACS Surgeons.   Good Luck.

Size and appearance differences behind versus in front of the muscle

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There definitely is a difference in appearance between the two different sized implants, one placed above and the other below your muscle. Even if they were the same size there would be a difference. The overall configuration is different between the 2 locations.

For most patients, I strongly recommend that the implants be placed behind the muscle. If you are even contemplating saline: go behind the muscle.

The question probably should be reframed to ask which size would look better behind the muscle.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 31 reviews

Breast Implant Volumes Over and Under the Muscle

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If you are deciding between 350 cc breast implants over the muscle and 420 cc breast implants under  the muscle, there are several points to consider. The 420 cc implants will appear larger. The difference will be more noticeable after all the swelling has resolved. I have noticed some small decreases in apparent volume with implants place behind the muscle (20-30 cc's), but this does not always happen.

More importantly, the shape of the breast will be different. Implants behind the muscle tend to give a more tapered upper pole. Implants in front of the muscle tend to look round, all the way around. It is easier to perform mammography with implants behind the muscle, and for implants greater than 350 cc, you may get better support for the implant behind the muscle.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast implants over or under, size is the same

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One of the great myths in breast augmentation is that an implant say, 350 cc will look smaller under the muscle than if placed over the muscle. The volume is the same, the breast shape may be different. If the pocket is made correctly to fit the implant, after the tissues relax and the implant and breast shape to one another the muscle will only provide better cover to the upper portion of the implant and reduce thinning and a round appearance of the upper edge. Sounds like you are trying to choose your own implants, and surgeons know that takes considerable experience and time. Choose the look you want and find the right surgeon to get you there.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Breast Implant Sizing

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Yes there is a moderate difference between 350cc implants over muscle and 420cc placed under the muscle. Although some plastic surgeons disagree, I do not feel there is a significant difference with time in volumes placed in these different areas.  My guess is that difference in your case would approximate one-fourth cup size.

John Whitt, MD (retired)
Louisville Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.