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 (25)

Are Breast Implants too big?

+5
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 42 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 25 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 51 reviews

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 781 reviews

380 or 410 cc breast implants

+1
Choosing an implant size is based on measurements taken by your physician and discussing your goals and size preference.  Sientra offers different profiles and contours and there are many implants to choose from.  It is important to try on sizes and even visualize via 3D imaging.  Choose a physician that can offer these resources to you as well as his professional advice and before and after photos that are similar to your current shape and size.  Sientra makes a great implant!

Alan N. Larsen, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 26 reviews

Are 380 or 410 Cc Implants too big?

+1
It is difficult to say without measuring your chest and breast diameter to see whether Sientra implants of either moderate or high profile of that size will fit properly. The Sientra implants of the sizes you mention are moderate profile and smooth, not textured, implants. Their widths are 12.8 cm and 13.0 cm respectively.  I suspect that, with your height and weight, these may be too wide for you. Problems can arise when your implants are wider than your breast and chest will allow. The result that you seek, as judged by your photo, is a pretty obviously implanted, as opposed to a natural, look. That is, of course, fine. You may require implants of that size in order to obtain that result, assuming that implants of that size will fit safely within your tissues. We have patients try on sizers preoperatively and choose the volume they desire, show us photos so we know how much upper pole fullness (how "implanted' a look) they want, and give us permission to decrease the size intraoperatively if the implants are way too tight, too "bulgy", and are not consistent with the result they are hoping for.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 71 reviews

Reasonable Request

+1
Achieving the result you desire may very well require implants in that size range.  While that might be a bit full for someone with your frame size and body type, the choice is yours.  I certainly wouldn't recommend an augmentation any larger than what you've shown but you should have enough elasticity to accommodate implants that size.  Keep in mind that your ultimate nipple position may not as you have indicated as your pre-op photo demonstrates more laterally-based nipples.  This is something you should discuss with your surgeon prior to surgery.

Jeffrey Weinzweig, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 9 reviews

Perfect size!

+1
I think you will do great with 380-410.  It appears that this will give you exactly what you're looking for.  Just be sure to express your concerns to your plastic surgeon.  The 2 of you will make a plan that fits YOUR goals.  Best of luck!

Dustin L. Reid, MD
Austin Plastic Surgeon
5.0 out of 5 stars 56 reviews

It is difficult to answer your question without measurements.

+1
We really need an examination, measurements, and a frank discussion with you to know what to say regarding the appropriateness of either of these two implants for your surgery.

If you had the chance to try these implants on, then you would have a very good idea of the proportion they will provide you. The other excellent way to view the potential result is to have 3D digital imaging performed with a device such as Vectra.

Keep in mind that the difference between a 380-cc implant and a 410-cc implant is 30-cc or 6 teaspoons. Not very much is it??

Lastly, when you say "Sientra Gummy Bear" implant, are you referring to their shaped or round implant? Common usage of the term "Gummy Bear" implant indicates a shaped implant. I've answered your question assuming a round implant since the shaped implant that comes with a round base is only available in the US with a high profile.

Best of luck!

Brian K. Brzowski, MD
Ogden Plastic Surgeon
5.0 out of 5 stars 25 reviews

Sientra Breast Implants

+1
Hi "S"
Yes you would need a high profile, otherwise you will get a side boob.  You might consider downsizing, but we do a lot of ethnic patients in your category and use the high profiles around the volumes you are looking at.  See the great answer below, by Dr. Law.  I already know you are seeing a board certified plastic surgeon because Sientra only sells to BC plastic surgeons (by ABPS - The American Board of Plastic Surgery) who are members of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). So that is great!
All the best "Dr. Joe"

Joe Gryskiewicz, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 56 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.