Do You Lose 50 Cc's with Behind the Muscle Silicone Implant Placement?

Silicone implants placed behind the muscle will generally look about 10-15% smaller than the implant that you may have tried on in your surgeons office.  The implants that you try on are outside your body and therefore appear larger.  Once the implant is place under the muscle during surgery, it is also under your own breast tissue and your chest muscle.  The muscle is tight and pushes the implant back resulting in less projection of the implant.  That is why the implant looks smaller once it is inside your body under the muscle.  If you try on a 300cc implant in the office and like the size, then you should choose a 325-350cc implant for your surgery.  Once the 325-350cc implant is placed under the muscle, it will look like the 300cc implant that you tried on in the office.

Submuscular placement which is most common will compress your implant more and so the same volume implant will appear somewhat smaller in this space compared to on top of the muscle.    

This is a great question as sizing is the most difficult part of a breast augmentation for women.  The implant can be placed above or below the muscle depending on the individual needs of each patient.  In the United States the most common method is under the muscle, however both methods are great if used in the correct situation. 

Placing the breast implant below the muscle helps decrease the risk of capsular contracture (abnormal scar tissue around the breast). It also helps women have a more natural and soft appearance to the breast as the muscle acts as an insulation layer between the skin and breast implant.  This will decrease the chance that their will be visible rippling of the breast implant as well. 



Placing the implant below the muscle does typically make the implant look slightly smaller as the muscle will give the implant a touch more of a natural slope.  It also compresses the implant, which makes the breast look slightly smaller.  When sizing I typically encourage my patients to go up one implant size, which is 30 to 50cc to make up for this difference.



I would encourage you to spend some time sizing and discussing your implant choices with your plastics surgeon.  Your board certified plastic surgeon can help guide you in finding an implant that will help you achieve your aesthetic goals.