Does going submuscular flatten implants after time? Should I pick a slightly larger volume to make up for this?

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. You should also be aware that results of surgery can change in the future with significant weight change and/or stretching of skin from the milk of pregnancy. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame

Dear bennib00,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It is not unreasonable to increase the size by about 10% due to compressive forces if breasts implants are not placed over the muscle. Submuscular is a better choice for a number of reasons including reduced risk of capsular contracture, better longevity, and greater implant coverage. Very few breast augmentation patients have enough breast tissue to permit a subglandular augmentation

Hi
Great question.
It really depends on the type and how firm the implants are. The volume doesnt change - just the shape. Smooth round implants are softer and the pec major muscle tends to flatten the upper pole and give a more prominent lower pole. This results in a more natural look but can cause bottoming out of the lower pole over time. Textured implants -either round or teardrop are firmer and less likely to be affected.
Cheers
Damien

There is some fattening with tightening your muscle with exercise, then it relaxes. I prefer the moderate plus, especially under the muscle. Please discuss your concerns with your surgeon.