Answer: Difference. Over time, the size will be about the same for under and over the muscle, however, under the muscle avoids the edge look and has less rippling and sagging. If you have minimal tissue or need a lift, placing the implants behind the muscle will give a better long term look.
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 the breast implant is placed above the muscle, the recovery is usually a lot easier and less painful. However, with under the muscle breast implants, you will normally have a longer recovery time, and for several days you may experience quite a bit of discomfort.
The truth is, whether implants are placed over or under the muscle, it will have very little to do with sagging. Sagging is commonly caused by weight gain or loss, pregnancy and gravity over time. It's easiest to remember it this way – it's the breasts that sag, not the implants.
Over time, the swelling resolves, the tissues loosen up, and the shape of the implant starts to exert itself on the overlying tissues. As a result, the implants settle into a lower, more aesthetically pleasing position on the chest. They appear softer and rounder, and they look larger and closer together.
After surgery, the implants tend to ride hide and appear small due to the patient's skin tightness in the area. There is tightness because the implants increase dimension to breast tissue causing the skin to compress the implant's shape and size.
Do implants look bigger when they drop and fluff? As the implant fills out the lower half of the breast, the implants can look bigger as they give the breasts a fuller, rounder contour.
The under the muscle or submuscular approach involves placing the implants below the chest muscle. This is usually a good option for women with little native breast tissue, as the muscle offers greater coverage. The results tend to look more natural than breasts that are placed above the muscle.
Directly after your procedure, you might notice that your implants are "riding high" on your chest and may look flatter than you'd hoped or slightly square in shape. These are normal occurrences caused by tight skin and muscle tissue that will gradually resolve as your implants drop and fluff over the coming weeks.
If you have a moderate amount of breast tissue: If you have approximately 3 cm or greater of breast tissue (your surgeon will tell you the amount of tissue you have), you have a real choice between above and below the muscle.
Advantages of over-the-muscle implant placement
Since the muscles are not affected in the procedure, swelling is less and patients experience less pain. The recovery is quicker, and your final results can be in place within weeks after surgery. Flexing your chest muscles will not affect the shape of the implant.
Generally, if you have minimal breast tissue and want larger implants, under the muscle placement will provide the best results as your pectoralis major muscles will help hide any possible rippling in your implants.
Popular implant size – The most popular size for breast implants is between 350 to 400 cc. For most patients, this would look like a small to a large C cup. In fact, all of the top 5 most popular sizes are between 350 to 500 cc.
How many ccs of volume do you lose under the muscle? Placing implants under the muscle leads to about 50cc loss of volume. What this means is that if you want 300 sizer breasts, you may need to opt for a 350 implant to achieve that result.
Your breasts may also look smaller than you were hoping for. At first, the muscle and breast tissues are tight, compressing your implant. In time, these tissues will relax and loosen, and the breast implant drop will occur and develop into a more natural-looking position. Your breast size may also increase slightly.
No, your breasts will not increase in size. As swelling goes down, your breasts will look smaller, however, they may also shift position by dropping into the pocket, and this can change the way they appear.
This is the “fluff.” The timing of this process is variable and depends on the patient. Generally speaking, implants begin to drop and fluff after a few days, approach their final position after six weeks, and settle entirely after three months.
Unlike subglandular implant placement, submuscular implants are less likely to interfere with mammography results. While submuscular implants may initially sit higher on the chest, they should descend gradually into a more natural position as the body adapts and swelling begins to settle down.
4 to 6 weeks post-op
Your breasts should look and feel more natural. Patients are advised to make an appointment with their surgeon for a full evaluation of the breast implants.
Wait for your implants to settle.
In the months following your breast augmentation, the muscles and skin around your implants will gradually relax. As this happens, your implants will drop slightly and fill out the lower halves of your breasts, while the tissue above them expands.
To help the process along, your surgeon may recommend you massage the implants or use a breast band to aid recovery. As you can see, there are a range of factors that affect the drop and fluff, but understanding the process and the outcomes is an essential part of your preparation.
While weight loss does not affect breast implants, women with more fatty tissue in their breasts are more likely to see changes after gaining or losing weight. Those with large amounts of fatty tissue could lose as much as a cup size after a weight loss of 20 or more pounds.
Breast implants can be used to transform your overall appearance and help you achieve a slimmer and more youthful look. While breast implants may not affect your stomach directly, they can be used to create the illusion of a trimmer figure and lift the bust area to provide more definition.
You can absolutely change your implant placement from under the muscle to subfascial, but there needs to be a good reason for it. This means that the benefits need to outweigh the risks of having surgery again.