How many CCs do you lose when going under the muscle during a breast augmentation?

Question

I understand that when going under the muscle during a breast augmentation the muscle compresses the implant. So when you try on sizers you are not getting an accurate representation of what you would look like with a particular size implant. If you like the way you look with a particular sized sizer, how many CCs would you go up in size to achieve that same look post-surgery? Put another way, is it possible to determine how many CCs you would "lose" when going under the muscle?

Rodger Shortt, FRCSC · Answer

Hi there,It is hard to judge how much perceived volume you will loose.  It would depend on the size of breast implant you are looking at and how firm it is.  It will also be influenced by how muscular you are.  A weak muscle will not be as tight as a very strong muscle.  Talk to your surgeon and advise them what you are looking for in the end result.   A good discussion will give them the tools to best match that.  I would assume in the "average" case you may want to go up 5% or so.Regards,Rodger ShorttOakville Plastic Surgeon

Martin Jugenburg, MD · Answer

Thank you for your question. It is difficult to determine the amount of cc's you would lose when going under the muscle. Schedule a consultation with a board certified plastic surgeon and discuss the look you desire and attempt to find a size to achieve that. All the best,

Curtis Wong, MD · Answer

but my rule is to add 10% to what is desired using external sizes in unlined bras and for the most part, my patients have been very happy with the end results very closely approximating what they thought they would get.  And still, my biggest complaint is "I wish I went larger".

Steven Wallach, MD · Answer

I do not think that you lose volume they just don't look the same as when you stuff your bra with a sizer.   Some patients feel that they lose volume, so they often request a slightly larger implant.

Tom J. Pousti, MD · Answer

Thank you for the question. No, in my opinion, it is not possible to accurately determine how many CCs the you would “lose” when undergoing sub muscular breast augmentation surgery.  I would suggest that you do not make your decisions based on statement such as: “you will lose 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. 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.

R. Stephen Mulholland, MD (retired) · Answer

Dear Choolova,

Your clinical question is actually very important.  One of the most difficult things in breast
augmentation plastic surgery has been trying to predict the kind of breast
implant size and shape that would best suit your aesthetic goals.  Using sizers or small bags of water or
specific amounts of rice will give you an indication of how much you will fill
a bra, but it does not give you a good, accurate representation of what the
implant will look like, either subglandular or submuscular.

Five years ago I purchased a photo station called the VECTRA®
3D.  The VECTRA® 3D will take your photo
in three dimensions and allow you to try on different sizes and shapes of
implants in different pockets and planes to get a very, very accurate
representation and simulation of what your breast augmentation shape will
probably look like in three dimensions and multiple views.  I would highly recommend you undergo a
VECTRA® 3D photo station assessment to truly identify the best possible breast
augment size and shape and pocket for you.

In general, submuscular implants will compromise projection
by about 20%, although there is by no means consensus on this number.

For more information, please review the link below.

I hope this information has been of some assistance and best
of luck.

Sincerely,

R. Stephen Mulholland, MD

Certified Plastic Surgeon

Yorkville, Toronto

Vincent D. Lepore, MD (retired) · Answer

One does not really "loose" CC volume when breast implants are placed beneath the Pectoralis major muscle.  However, the final breast shape may be somewhat flatter than if the same implant was placed above the muscle.  The strength and thickness of the muscle, and elasticity of the  breast/chest tissues will ultimately determine how much projection one can achieve with any particular implant.  Discuss this issue with your surgeon as they will be able to help you determine which size and shape of implant will suit you best.

How many CCs do you lose when going under the muscle during a breast augmentation?

Answers (7)

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