How Smaller Will Breast Implants Be Once Under the Muscle?

Question

I am having breast augmentation surgery next week. I'm 5'3, 135 pounds, currently a 36B and wanting a full C. I chose silicone implants and 480CC. I'm afraid it'll be too big. Is that too big for a full C? I've had friends that have done it said they wished they went bigger.  How much smaller will it be once the implant is under the muscle?

Vincent N. Zubowicz, MD · Answer

There are reasons to place a breast implant below the muscle and reasons to place it above. These will be discussed by your plastic surgeon. 480cc is large, particularly with you stature but most women wish they had gone with larger implants when queried a year or so after the operation. The average implant is around 300cc, though. 480 might put you in the D cup are which is fine if that's what you are after. Sounds like you might want to discuss size again with your surgeon.

Farbod Esmailian, MD · Answer

Very difficult to say what size you will be after surgery and cup size is very different depending on the bra it self.  But having said that you will likely be more than one cup size larger with that size.
What you need to do is talk to your plastic surgeon, do the "rice test" (explanation is found on my website) or try out sizers and see what look you are going for.
Go for a look, given that the implant fits your body and they see what bra size you wind up being, no vice versa.

David Bogue, MD · Answer

480cc implants are very large implants. At your stature, these will be larger than a full "C" and more likely in the "D" cup size. Remember that although the number is consistent among bras (simply the circumference of your chest), the cup size varies considerably between manufacturers. Placing these implants under the muscle doesn't change the size or shape of the breast, but rather provides more tissue between the implants and the skin to hide the edges of the implant.

Tom J. Pousti, MD · Answer

Placing impants submuscularly does not necessarily make the breasts look smaller, it just gives them a more natural look and keeps the implant more supported under the muscle. To determine cup size is very difficult and could depend on the manufacturer of the bra. I woud suggest finding pictures of what you would like to achieve size wise and shape to explain to your plastic surgeon.

	Your board certified plastic surgeon shoud be able to determine which size implants to use to fulfill your goals. Once in the operating room sizers may be used to determine actual sizes needed. You may need different volumes to achieve symmetry as well. For more information regarding size and breast augmentation, please check out my website and compare before and after photos of pateints. Good luck.

Michael C. Edwards, MD, FACS · Answer

Every patient is different in how their tissues will respond to a given implant placed above or below the muscle. I have all of my patients size with the actual size/style/type of implants they will have at surgery. I tell them all that they will be a little smaller than what they see but the more breast tissue they have before surgery, the greater the difference in what they will achieve. In other words, if a woman has minimal to no breast tissue to speak of, what they see with an implant in a sports bra is pretty predictive of their results. As your plastic surgeon to allow you to size with 480cc implants and look at yourself in the mirror. I also recommend that you bring someone along with you whose opinion you trust to give their input. Best of luck.
Dr Edwards

Robin T.W. Yuan, MD · Answer

Volume of an implant in augmentation is a by-product of the analysis, not the goal itself. That is, there are different implants with the same volume that give you different results. Volume by itself does not determine the final result. Your surgeon should go through an analysis of your normal breast dimensions, envision you goal as far as appearance and proportion, and then determine what range of available implants will give you the closest fit to your goal. Much of it will depend on what you start with. A 480cc implant will produce different results depending on what your natural breasts are like and what style is used.
I always ask the question of a patient: If you come out bigger than you want or smaller than you want, which situation would make you more unhappy. What I have found is that while studies have shown more women may have wished they had gone bigger, the women who are too big, are more unhappy because they cannot hide their size as much as an undersized woman can augment her breasts with bras. Different women with different personalities will answer the question differently. A careful analysis and even more careful questioning of a patient will allow a high rate of satisfaction. For your information, I have not used an implant of the size you mentioned in a very long time but you should be satisfied with the rationale and process of choosing your implant with your own surgeon.

Peter E. Johnson, MD · Answer

The size and volume of a breast implant will not change with a subglandular vs a submuscular placement. The reason to place the implant under the muscle is to provide better cover to hide the upper edge of the implant, and reduce the rounding up and capsule contracture more common with a subglandular implant. The reason to place an implant under the breast only is to take up skin excesses, especially with breast lift, prevent muscle distortion of the implant, or to allow for a very full implant which cannot fit comfortably under the muscle. The correct placement should be apparent after a thorough consultation. After the  "look" is decided, what implant achieves the result you wish should matter little. It is a wonder to me that you have decided on a 480cc implant. Perhaps your surgeon, who has performed hundreds of breast augmentation procedures should bear the burden of choice for you. My impression is that your implant may achieve a "D" cup. Your friends may indeed wish that they were bigger, but it is what you want that matters most.
Best of luck,
peterejohnsonmd

Steven Wallach, MD · Answer

480 cc implants when you start out as a B will probably put you in the "D" category. I don't think that putting them under or over the muscle will really make a big difference in overall size.

Paul C. Zwiebel, MD (retired) · Answer

Implants look about 10% smaller under the muscle than they do when you try them on in a bra.

	Nonetheless, 480cc sounds a bit big for your stated goals.

	If the look seems right when you try on the implants, you may choose to stay with that size, but you can expect your bra cup size to be at least a D. 

	Your sense of balance and proportion is more important than the label on your bra.

Richard P. Rand, MD, FACS (retired) · Answer

If you place a sizer implant in a garment of about 50 cc's smaller than the one you are going to use, it can give you a ballpark idea of the look you will get from the surgery. This plus the fact that there are about 200-240 cc's in a cup size, at your height this 480 implant will probably exceed a C cup. You need to be happy though and should work with your doctor to check on this.

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