Unders or Overs and What Size Implant to Achieve a D/DD Look?

I am 5ft9 and currently a 32b, I am a UK size 6 or 8 and I want to achieve a D/DD max, I was offered 375 or 410cc CUI max for under the muscle but I was told I could have 460cc if I had overs as he would not put a large implant under the muscle, I am worried that with overs they will sag alot quicker and also look very false?

Doctor Answers 5

Under or Over

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I am not sure I understand the rational for putting in one size implant over and another size under.   I would stick with the larger implant and go under the muscle.  You will get a nice result.  Cup size is hard to predict because as you know it changes from Victoria's Secret to Nordstroms.  As you are thin, a sub muscular implant will decrease your chance of rippling  You would be a great candidate for an endoscopic trans-axillary incision. 

La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

D cup Breast Implants Under or Over

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You are tall and as such D or DD cup will still look very natural on you.  For someone of your stature 220 ccs would achieve a one cupsize enhancement.  Using that math I would suggest something in the 400 to 450 cc range.  Implants of this size would be placed under the muscle in my practice (as 95% of them are).  You are also thin and  therefore I would be concerned about seeing edges through the skin with an implant on top of the muscle.  If you are willing to use a saline implant, you look to be a great candidate for a TUBA procedure which places the implants under the muscle via a small, virtually invisible scar in the belly button.

Christopher J. Schaffer, MD
Birmingham Plastic Surgeon


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The best way to choose the appropriate implant for you would be to examine you in person.  It is best to go for a consult to get the appropriate exam.

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

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Dual plane (under the muscle) breast implants

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A submuscular implant, with partial attenuation of the lower pole of the pectoralis will help you achieve a natural and tear drop shape to your breasts. Surgery90210

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Deciding Over the Muscle vs. Under the Muscle and Breast Implant Size?

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Thank you for your question.

I  usually recommend sub-muscular (dual plane) breast implant placement. I believe that there are many advantages of placing implants in this position.     Although I cannot give you specific advice without direct examination and a full communication of your goals I would suggest that you:

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.


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.