How Much Smaller Do the Breasts Look when Going from Overs to Unders?

I have Mod+ 325s silcon overs. My new implants will be unders. My revision is due to capsular contraction. My PS said they will look smaller under the muscle. I am 5'5", 110 lbs, 32DDs. I'd like to go down a cup size so I'm wondering if I should ask for a smaller implant although I would need a lift.

Doctor Answers 5

How Much Smaller Do the Breasts Look when Going from Overs to Unders?

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For saline implants, I tell patients they will lose 10-15% of the volume and for silicone implants, I tell patients they will lose 15-20% of volume when transitioning from over to under.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Implant position

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The actual volume of the implants are obviously the same but the look may appear slighly smaller under the muscle based upon the slope.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Size difference above and below the pectoralis muscle

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Your plastic surgeon is correct. If you take the same size (dimension and volume) implant from above the pectoralis muscle and put it in a new pocket below the pectoralis muscle, it will look smaller. It will not actually be smaller but it will look as if it is. I would agree with Dr. Rand that it will look about 1/4 to 1/2 cup smaller. This is one of the difficulties with figuring the size and looks of a breast by putting implants or some filler in a bra externally. The same volume doesn't have the same effect in the real position. 

There are several other issues here. Capsule contracture could be due to low grade bacteria on or around the implant and changing the implant pocket is one way to address this. There is a general feeling that the implant should be changed too. The new implant in a new pocket has to be sized properly and it is hard to know how to fit the implant and go down a cup size. You will probably need a lower profile and a width that matches your true breast width which along with the apparent decrease in size effect, might get you to a cup size smaller. 

I would add that in my opinion, the size or type of the implant has nothing to do with capsule contracture. It is not true that you would need a lift with a smaller implant. Implants do not lift the breast and taking them out or using a smaller one (presuming it still fits the breast width) will not make a breast sag. Sag of the breast and the need or benefit of a lift is a separate issue. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Breast size will not change, over to under the muscle

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The truth is that the implant and breast volume will be the same whether the implant is under or over the chest muscle. What does change is the profile of the implant. Under the muscle the implant may begin with a slightly lower profile, but this will balance as the muscle and breast relax to accommodate the the new shape. At this point there will be little difference. Capsule contracture is one of the biggest problems with 'perceived' volume of the breast. In the case of a subglandular implant which has become contracted, the implant rounds up and pushes forward causing the implant to feel bigger as it projects and covers a smaller area. The release of the capsule will make the implant 'feel' smaller. When we replace old subglandular silicone gel implants we often exchange the implants for a larger one if the patient wants a soft implant that 'feels' the same size as the old one. If you want to be smaller yet, fine. Remember though that lift is about nipple position, not implant size.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Under the muscle breast implants lose about 50cc of volume

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By placing an implant under the muscle, you lose about 50 cc's of the look you get when they are placed in a garment.  50 cc's is about 1/4 cup size.  So this is a situation where you and your surgeon would need to work out the details and get the look you want.

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.