300 over muscle to 285 cc under muscle. Is there much of a difference?

Question

I originally had 300cc high profile over the muscle. I had a capsular contracture, so implants were changed to under the muscle this time around. 285cc high profile. Is there much of a difference? I want to still be a 32d - 32dd

Urmen Desai, MD, MPH, FACS · Answer

You "lose" 50ccs when placed behind the muscle.    I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Daniel Barrett, MD · Answer

Dear catslover,Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Charles Nduka, MD · Answer

It would be difficult to give an accurate assessment based only on description. Implant size will look different on each individual due to different chest wall measurements and skin elasticity. Aside from these, other factors which affect the result of breast augmentation would be your desired result and the technique and skill of your surgeon. Generally speaking, there is not much difference between the two sizes, but with regards to the cup size, it would be difficult to say which cup you'll end up with as there is no direct relation between implant size and cup size.

Robert L. Kraft, MD, FACS · Answer

Placing the implants under the muscle is beneficial for capsular contracture. However, lowering the volume combined with the placement will decrease breast size. You may want to discuss further with your plastic surgeon.

David E. Berman, MD (retired) · Answer

my suggestion if you want to keep a more similar appearance is for you to slightly increase, not decrease the implant size. It is definitely wise to switch them from over to under the muscle.david berman md

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Cats Lover,Hello and thank you for your excellent question.  At the time of your breast implant revision, you may want to look into the Bellesoma Breast Lift technique - it provides an exceptional breast lift, upper pole fullness, relief from neck and back pain, and no vertical breast lift scar. It uses a woman’s OWN breast tissue to produce an internal suspension technique, without the need for a breast implant. It does not disturb the nipple, areola, or breast glands, so sensation and the ability to lactate is preserved. It uses 3D scanning of your breasts and body to design a procedure specifically designed for YOU, and you alone. Finally, for patients who desire breast enlargement, it can be combined with fat grafting. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018

Ronald V. DeMars, MD (Retired) · Answer

The difference is so small (1 tablespoon) that I doubt it would be noticed but the projection may be a bit less under the muscle. That is not always the case however and is rarely the case when a dual plane positioning is performed. It is sometimes popular to say you "lose" volume by going under the muscle due to the muscle contraction but that is only very temporary.

300 over muscle to 285 cc under muscle. Is there much of a difference?

Answers (7)

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