How many cc's are lost going under the muscle ? And how much a difference between 350 and 375 hp?

Thank you for the question. No, in my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. In regards to breast implant volume: much will depend on your specific anatomic features; for example, a 25 cc difference may be noticeable on a very petite patient but not on a patient with a larger frame. Therefore, the advice you receive online will not be specific enough to be very helpful.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 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 or D cup” etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.

Thank you for sharing your excellent question.  In terms of appearance patients do not lose any cc's by going underneath the muscle as the implant will redistribute its volume to the lower portion of the implant as it "drops" during the healing process.  In most cases 25cc is not a substantial difference when considered over the entire size of an implant, but this will depend on your current frame.  Talk to your surgeon about your desired goals they should be able to best steer you to the right size to meet your expectations. 

Thank you for your inquiry and photos. Without a physical
examination it is difficult to respond with accuracy, but whether or not your implant is under the muscle or above the muscle will not impact on the volume. You are probably asking if the "look" will be different and this is based on many factors, including the thickness of your breast tissue. Most plastic surgeon recommend the placement be under the muscle for many reasons. The best way to
determine which breast implant size is best for you is by first finding out
your specific wishes not only with words or letters as in cup size or “not too
big” or “natural”, but also with a visual understanding of what you hope to
look like. This can be accomplished either with photographs of patients whose
breasts and body type look like you, or ideally with photos of patients not
only whose breasts and body type visually are similar to yours, but are also a
similar height, weight, and pre-operative breast size. In our own practice we
have provided that unique functionality on our website to accomplish exactly
that.

Unfortunately the most common reason for a woman to be
unhappy after her augmentation is feeling as though she is either too big or
not big enough. Thankfully, in our practice this is rarely a problem because
implant size selection is what we spend most of our time discussing and
determining. I do not place the onus of selecting the breast implant size on my
patients since they are coming to me for my advice and expertise, but I do ask
my patients to be as specific as possible about their aesthetic goals and I then
advise them accordingly.

I would advise you to seek the advice of a board certified
plastic surgeon experienced in breast enhancement surgery and make sure that
your own sense of aesthetics aligns with that of your plastic surgeon. Your
idea of “natural” or “pretty” or “proportionate” might be different from your
plastic surgeon’s and it is very important for you to feel confident that you
are both of like minds as far as the goals. Best of luck to you and I hope you
are successful in achieving the enhancement you are seeking.