Are 380 or 410 Cc Implants to Big? (photo)

I'm 34yrs old, 5'1 and 124 lbs. I'm a 34 A cup. I would like to be a full C to small D. My doc chose 380 or 410cc round moderate profile Sientra "gummy bear" implants under the muscle. I'm a little concerned because I think that I might not have enough tissue to support that size.

Doctor Answers (19)

Are Breast Implants too big?

+7
You are absolutely correct in being concerned about the implant volume that has been recommended to you.  At 5’1” / 124 lbs and with and A cup breast volume, your natural breast base diameter is probably 11.0 - 11.5 cm.  At that base diameter, a volume of 380-410cc by definition means high profile breast implants, which will look completely unnatural on your frame.  

Or, it could be the recommended implant is a moderate-profile device, but at that volume (380-410cc) the base diameter will be too wide for your breasts (12.5 to 13 cm or more) and you will end up with augmented breasts that appear oddly wide, and visible implant folds and ripples. If your surgeon uses biodimensional planning principles it would be obvious to you, as he or she would have spent several minutes making and recording a number of breast measurements using a tape measure. Biodimensional planning takes into consideration a number of important measurements including base diameter and the change in the length of the lower pole when stretched, and if your surgeon used it they would have most likely arrived at a lower recommended implant volume.

Here’s one of the most important things to understand about breast augmentation – maybe THE most important: based on the breast ‘soft tissue envelope’ that you are starting with, and by that I mean the breast skin and subcutaneous breast tissue that will cover and conceal your implants, there is a limited range of implant shapes, dimensions and volumes that will produce 1. A natural-appearing result, which in turn provides you with 2. A very low likelihood of needing a reoperation (or a series of reoperations) for the problems associated with overly large breast implants: visible implant folds and ripples, implant malposition (usually ‘bottoming out’ and/or ‘lateral drift’), lower pole skin stretch deformity, easy implant palpability, stretchmarks and capsular contracture.

And yes, I do believe overly large implants have a higher rate of capsular contracture, for any one or all of the following reasons: a possible direct mechanical adverse effect on breast soft tissues; the fact that the bigger the implant is (i.e. the lower the ratio of natural breast volume to implant volume) the more obvious a mild or moderate contracture will be; and what I think is a high probability that surgeons who are willing to place unnaturally large breast implants are, as a group, less likely to be compulsive about using the intra-operative measures and techniques that have been shown to lower the incidence of capsular contracture.

If you want a natural-appearing result that is stable in appearance over time, find a surgeon who uses biodimensional planning principles and who recommends a smaller volume, moderate projection implant.  Given your body size and the size of your natural breast (A), you are probably a perfect candidate for shaped, form-stable implants.  275 – 300cc is plenty of implant for you, maybe 350 at the most depending on your actual measurements.  Don’t obsess about ‘C’ or ‘D’. Just ask the surgeon for the fullest volume breast implant that your natural breast tissue can effectively conceal (and not just for the short term but over time) based on biodimensional planning. You’ll get an outcome that looks full and beautiful but also natural, and that doesn’t cause you problems that lead to frustrating reoperations with a few months or years of your augmentation surgery. 


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 37 reviews

Being Conservative Has Its Rewards

+3

You appear to have  beautiful, slightly asymmetric breasts and should be careful about going to big.  Do you really want to look like the photo on the far right..two large, round cantaloupes stuck on your chest???  

While your own tissue may accommodate implants with these volumes you should go through a careful sizing/ measurement protocol to determine the ideal implants to get you to a "C-cup".  It's also difficult to tell from your photograph but it appears as if your breasts are slightly asymmetric and you may benefit from two different sized implants.  And yes, I do agree that 380 or 410 are probably too big!  I would probably recommend implants in the low 300 range as they would better enhance the shape of your own breasts while getting you to the size you desire...GOOD LUCK!

Eric Sadeh, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 22 reviews

Enough tissue for bam

+2

It doesn't sound like it should be a problem.  The skin has a lot of elasticity, and I have patients of equal proportions who do well with even larger implants.  It is important to feel comfortable with your choice, so talk to your ps again before surgery

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 45 reviews

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Best Breast Implant Size/ Profile for Me?

+2

Thank you for the question and pictures.  Unfortunately, online consultants are not in a position to provide you with precise enough advice.
The best online advice I can give to ladies who are considering breast augmentation surgery 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'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 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 “full C to small D cup” or "too big" 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.





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 (and the attached link) help.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Sientra Breast Implants Sizing

+1
Congratulations or your decision to use a Sientra implant! Deciding to get a breast augmentation is not trivial and it sounds like you are doing your homework.

Most plastic surgeons decide what size or size range is appropriate based on the diameter of you breast. While there are a number of considerations that may alter that range slightly, using the diameter of your breast (the distance from your breast bone or sternum to the side of your chest). One way to think of this is to consider two balls; a tennis ball and a basketball. We can only go so far towards the middle on each side and so far down your chest in the area of your inframammary fold and as a result we are limited the position of corner of your inside lower breast. If we put a tennis ball there it would not look right and obviously not be enough. Conversely, a basketball placed starting at this corner would have its outside edge somewhere on your back and its upper edge up by your shoulder tip. Usually, using the base diameter of your breast gives you just the right implant width. We then go to implant projection to give you added size up front.

In order to determine a size range you would need to be measured or fitted to see what would work. I will usually give you a maximum and then we try on breast implant sizers to help you make the choice of size.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
5.0 out of 5 stars 7 reviews

Correct size shaped sientra implants

+1
correct size shaped sientra implants
the volume chosen is on the high side and you need to check the base diameter as well
the photo shown is fairly round and large in my opinion

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 15 reviews

Size of implants too big

+1
The breast measurements are critical to correctly answer your question.  This is the reason a consult is a priority.  It appears that you are implanted already.  If all has healed, but you feel too large, then reconnect with your surgeon.  We want satisfied patients and if the size is too large it is not the same operation to change them out with regard to recovery.  Having said that, observe for now and after 4-6 months see if you are still uncomfortable, but reconsult with your surgeon, he or she will be more than happy to make you a happy patient.

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 17 reviews

Sientra implant for shorter patient

+1
It is very poor advice to be suggesting someone your size needs a 400cc device and shows that your surgeon is thing more in terms of volume rather then modern implant planning which respects your native anatomy and tissue thickness. A device that size will look both unnatural and be associated with more potential issues over time as the dissection would require significant expansion of your existing breast borders

while I personally think your pictures make you a good candidate for a shaped device (Sientra's round base shaped device is outstanding) I would think you'd need to be in the low 300 range. As Sientra high profile devices aren't particularly projecting compared to Mentor or Allergan devices, I'd think that would be the model I'd use from there line. Would also go textured over smooth surface to decrease risk of hardening

Robert Oliver Jr., MD
Birmingham Plastic Surgeon

Implant Selection

+1
Implant selection is, in my opinion, best done during a forma consultation in a dareful and logical fashion.  Patient goals and physical examination are necessary in order to give any meaningful concrete advice about a partiular implant for you - an on line straw poll will give you unhelpful advice - or worse.  Select your surgeon carefully.  I f you believe your surgeon understands what you want and has a logical plan for achieving it, then you will very likely be highly satisfied with the result.

Michael B. Tantillo, MD
Boston Plastic Surgeon
4.5 out of 5 stars 12 reviews

Choosing the right implant size for your body

+1
Choosing the right implant size for your body

Choosing an implant size is the one thing all breast augmentation patients struggle with. They don’t want to look too big, but also don’t want to go too small. There are many things to take into account when determining size. Your height and weight is a factor, but the most important thing to measure is the base diameter (width) of your breasts. Your surgeon will measure the base diameter to choose an implant range that will work for you. There are different styles, shapes and textures and there are three different manufacturers to choose from as well. In my practice we offer Vectra 3D imaging. This camera takes a 3D image and can take your exact measurements. It can tell us if one breast is larger than the other, or higher or lower and by how much. This incredible technology allows us to take a 3D photo of you and then “implant” different sizes and projections of implants. You can see these implants of “your” body to help you better understand what size will work well for you. With Vectra we can even but a bathing suit or bra on the image and we can rotate the image so you can see what your “augmented” breasts will look like laying down. This technology has greatly increased the ability to choose “the perfect implant” for each patient. With so many options in size to choose from, as long as you are staying within your base diameter measurement, you should be happy with the outcome. Look for a surgeon who uses Vectra and you can see your “after” photo, before surgery!

Christopher T. Maloney Jr., MD
Tucson Plastic Surgeon
5.0 out of 5 stars 9 reviews

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.