My Surgeon Said He Doesnt Do Any Larger Than 410cc Under the Muscle? (photo)

I went to see my surgeon and he said that the max he would do and does do under the muscle is 410 cc which is guess would be 400/420 cc if I upgraded to extra high profile.....He said that I could have overs aswell, which suprised me as im only slim, and a 32b so not too much breast tissue, but he said that I could opt for a larger sized implant if I had over the muscle, which would be 445 or 470cc, is there any reason some surgeons dont do large implants under the muscle?

Doctor Answers 16

Best size for you

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Recommending implant sizes for you depends on multiple factors.  Selecting an implant size is dependent on patients' anatomy (height, weight, chest width, chest height) as well as patients' wishes.  It is hard to give you a recommendation without examining you. You should try some sizers and talk with your plastic surgeon.  Please remember that implant cc volume does not correlate with cup sizes. Also, try to look at pre and postop photos that reflect your body size and desired look.  Hope this is helpful.
Dr. Kim

Breast implant choice

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There is no hard and fast rule about the size of implants that can be placed in a given patient.  It certianly does depend upon your anatomy, but your goals have to be taken into consideration as well. Go for another opinion.

Eventually, it's not really "under the muscle"

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The real issue is how is your decision now going to effect you in 10 years.  A "big" implant (and for you that would be anything over 350cc or so) placed under the muscle will only be about 60% under the muscle.  The bigger the implant, the more the surgeon has to release the muscle, the less it's under the muscle.  An 800cc implant in you (which I think is a VERY bad idea) will lead to multiple problems down the road.  The recommendations a surgeon makes for you should be based not only on what you want to achieve, but also keep you out of trouble in the future.  Bigger is not always better.  Good luck!

Retro-pectoral implants are size limited

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You have described yourself as slim and a 32 B.  Each 100 cc of implant will correspond to 1 cup size change.  400 cc implants will take up to approximately a size F.  A large implant like this may not fit under the muscle.  If too large implants are placed, the muscle can tear or the implant will dislocate inferiorly and laterally.  You will lose your projection because the implant has descended.  The goal of breast surgery is to achieve beautiful breasts.  Beaut is determined by multiple factors not just size.  Position on the chest wall, symmetry, roundness, nipple position and least of all volume.  Implants should be proprotionate to the size of the patient.  All these may be reasons your surgeon won't recommend larger than 410 cc implants.

Best Wishes,

Gary Horndeski, M.D.

Best Breast Implants For Me?

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Thank you for your question and photos.

Sounds like this surgeon has a preference for not going larger than 410cc.  You may need to ask him why he has this “preference”.  It's still in doubt, it will not hurt to seek additional consultations with well experienced  board-certified plastic surgeons.

 Although I cannot give you specific advice online,I would suggest that you do the following:

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're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This if communication will be critical in determining which operation and/or 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”  etc 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.

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 hope this helps.


Implant Size

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Yes it definitely sounds like this is your surgeons personal preference. I would look in your area (or others) for some second opinions.



My Surgeon Said He Doesnt Do Any Larger Than 410cc Under the Muscle

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Sounds like a very personal decision by your surgeon. Best to seek additional in person evaluations from boarded PSs in your city

Implant size selection

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There is no upper limit of implant size that can be placed under the muscle.  There are a number of factors that help determine the range of implants that will safely help you achieve your goals.

I consider two factors when selecting implants for my patients:
1.Dimensional planning  2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. Even your fitness levels and other relevant criteria are taken into consideration. It is you who will decide what you are comfortable with.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for.

This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.

Hope this helps.

Dr. Basu

Houston, TX

Maimum Breast Implant Volume of 410 cc Needs to Be Tailored to the Individual

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Dear xxlauren90xx-


Thanks for the great question!  In general, it's unusual for a surgeon to be do adamant about  doing a breast augmentation with only certain volume breast implants with above versus below muscle placement.   There are a lot of variables, including


-  your personal measurements, regarding breast width, breast volume, rib cage

-  the tightness or laxity of your breast skin

-  the amount of breast tissue you currently have

-  the volume and profile of your breast implant, and what manufacturer is making the breast implant, since the dimensions may vary a little


So, given all of these variables, it should be possible to go larger than 410 cc breast implants, under the muscle.  Of course, the only way to really tell is with a consultation with a plastic surgeon, in person, where you will probably be measured, and you can try on sizers or undergo software image manipulation to give you an idea of what you would look like "before" and "after" your surgery.


Best Wishes,

Roy Kim, MD

Roy Kim, MD
San Francisco Plastic Surgeon

My Surgeon Said He Doesnt Do Any Larger Than 410cc Under the Muscle?

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There are a number of factors that go into choosing implant size and position. Patient preference is paramount, as long as the goal does not interfere with realistic limitations that the patients body may present. For example, we like to limit the width of the implant to the width of the patient's breast. Tightness of the skin may limit the size that will look reasonable.

I don't know of a reason why a larger implant could be placed above the muscle vs under the muscle. For instance, just today two of my implant operations had implants about the size you are considering, and in both cases they are under the muscle. 

If the size and position are important to you (as they should be) you should consider getting other opinions.

Thanks for the question, best wishes.

Jourdan Gottlieb, MD
Seattle 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.