Breast Implant Placement Revision and Size

If I had breast augmentation with 375cc and 350cc implants over the muscle and they are removed and placed under the muscle without changing the size, will my breasts still be a 36 D cup, or will the size be smaller due to them being placed under the muscle?

Doctor Answers 16

No Size Guarantee After Breast Revision

Breast revision surgery is more difficult, complicated, and requires more time than primary surgery. There is as much as a 40% chance additional surgery will be needed following the #revision. As far as sizing, there are no promise or guarantee of the specific cup/bra #size and shape you will be after your surgery.  Implants which are under the muscle or are placed in a new position under the muscle may change with shape on muscle contracture and may have “#banding” and motion of the implants with muscle contracture. If this is unsatisfactory, it may require additional surgery which will also require additional surgeon’s fees, operating room and anesthetic fees.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews


There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.
Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.
I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.
By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.
I hope this helps. Good luck!

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

The same volume-no change

It will be about the sam the shape may change some but the overall volume will be about the same. Good luck

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 75 reviews

Breast implant revision

Much of the final “look” achieved after breast augmentation revision surgery  depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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 cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Revision implants

If you change your implant ppocket positon form overs to under the muscle and use the same implants, it should be the same cup size.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast size is the same after implant revision

You might appear fuller in the upper pole, but generally, the breast size is the same after revision. Maybe you should consider slightly larger breast implants. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Breast size following breast augmentation revision

You are going to hear a lot of different opinions on this topic. For my patients, I tell them that this changing the implant pocket from a subglandular position to a submuscular position makes the breast mound SEEM a little smaller. This is a perceptive change because of the way the natural tissue drapes following the implant change. I usually increase the size of the implant by about 50cc when revising breast augmentations like this in Santa Barbara, and have universally found my patients to be happy with this.

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 56 reviews

Breast size shouldn't change when switching implants from over to under the muscle

Hi Doingitagain - The general size of your breasts should stay the same, as the volume of muscle will only add a little to the overall size of your breasts. Expect some swelling after the surgery, so you will be big right after. When the swelling has resolved (6-8 weeks) you should realize the actual size of your breasts.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

Breast Implants placed under muscle will generally not change cup size

Generally speaking, converting your implants from on top of the muscle to a position below the muscle will not change your cup size. When the implants are placed under the muscle, it usually means a partial sub-muscular position. The lower one half to one third of the implant remains in a sub-glandular position and therefore does not change the cup size.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 40 reviews

Change in Breast Size by Moving Implant from Over- to Under the Muscle

Generally speaking, an implant placed under the breast (subglandualr) gland yet over the pectoralis muscle pushes the breast forward with less opposition resulting in MORE projection than if it had been placed under the breast gland AND under the muscle. (YET - there are important benefits of placing a saline breast implant in the under the muscle position).

When an subglandular implant is relocated to a deeper under the muscle position, it is done for several possible reasons (such as visible implant shell rippling, capsular scar contracture etc) - all of which already changed the shape of the breast.

Doing so also provides both the patient and the surgeon a partial "Do - Over" to correct past mistakes and start anew. Do not put in heavy implants (which will sag faster. Do not put in overly wide implants - asking for a "positive pencil sign" cleavage - as a result of whose implants pockets may merge to give you an uncorrectable "uni boob" etc.

Ask your surgeon what would be the best approach for an attractive AND long-lasting result and go with it.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

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.