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 28

Are Breast Implants too big?

You are absolutely correct in being concerned about the implant volume that has been recommended to you. Look at my breast augmnetation gallery of 100+ women to see what I mean.  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 66 reviews

Being Conservative Has Its Rewards

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 39 reviews

Are 380 or 410 Cc Implants too big?

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.

Enough tissue for bam

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

Best Breast Implant Size/ Profile for Me?

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.

Pushing it but it might work... i don't like that idea, do you?

Putting in a larger implant than your body is designed for "might" work, but I don't like operating based on "might" or "could". I would choose a HP implant that fits your base width, which is probably around 11. That means about 285cc to 315cc. In that range, you will have the most natural result and the least likelihood of problems like stretch marks, drooping and asymmetry. You probably will NOT have the look of your wish pic, but you will have your wish of hopefully NEVER NEEDING SURGERY AGAIN. That really is my goal and should be yours too. If your tissues have adjusted to the bigger size and you really really want to be bigger, then it is possible to do an exchange once your tissues have stretched, but I don't really like doing this and I think natural breasts that are full (HP will give you this) is preferable to having an implant related complication.

Choosing the right breast implants

Choosing the right breast size really depends on your breast biometrics, including breast diameter and current volume.  I would speak to your surgeon during your exam and choose the right implant that complements your body, rib cage, desired aesthetics, and skin. 


Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 64 reviews

Sientra breast implant size

There are two issues (at least) to consider. The first is will the chosen implant size give you what you want, and the second is what cup size that will be.  In general we try not to go by cup sizes and concentrate on your goals, so the first question is the most important.  I trust that you and your plastic surgeon have gone through many photos, done implants in a bra as trial, done the rice test, and discussed your goals at length.  If that is the case, then trust his/her choice. If that is not the case, then go back and have further discussions.

No one can predict the final look and size of any breast augmentation, even with computer imaging, so your choice of plastic surgeon is the most important. Best wishes.

Below is a patient with Sientra breast implants and her result.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 24 reviews

380 or 410 cc breast implants

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!

Reasonable Request

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 20 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.