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 33

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
5.0 out of 5 stars 70 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.


It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 76 reviews

Moderate sized implants usually create the best results.

Going too big is a common concern, both for aesthetic and health reasons, so it's wise to question the increased volume in regards to your end goals. While skin has a lot of elasticity, and the tissue and muscle in your chest may compensate for the volume you're thinking about adding, your height and weight proportions suggest that 410cc implants may be a bit big. An in-office consultation is always recommended, but to complement your figure and get the most long-lasting, complication-free results, you may want to consider something more proportionate.

That sounds big...

No one should tell you what size to get without examining you, but since you asked...

Based upon the photo you included of how you want to look those implants are probably in the size range necessary to get you that look (though I would think a moderate plus rather than a moderate would fit better.)

However those are very large implants for someone your size.  Do you want to look fake?  It isn't possible to put in something that large without looking obviously augmented.  And an implant that size will stretch and thin your tissue over time making you implant more easy to feel. 

Are you willing to pay that price for that look?  If so it is your choice.  If those issues are of concern to you it is time to review your plan.

Steven Teitelbaum, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 37 reviews

Computer imaging may be helpful for you.

One of the most important decisions facing breast augmentation patients is the size of breast implants that will be used.Most patient are striving for harmony, balance and proportion with the surrounding anatomic structures. Typically, they want a natural look with some fullness in the upper breast area.
Although your pictures are helpful, it’s virtually impossible to make a specific recommendation without a physical examination.The determination of breast implant size can be difficult for a variety of reasons.For instance, most patients speak in terms of cup size.Unfortunately, every woman’s idea of cup size is different and for this reason most plastic surgeons prefer other methods to determine breast size.Furthermore, cup size doesn’t easily translate into cc’s when determining breast volume.
In an effort to determine breast size in a more objective manner, we utilize external silicone sizers and the Vectra 3D computer imaging system.External silicone sizers are designed to sit on top of the patients breasts.They can be held against the patient’s chest or placed inside the patient’s bra.This technique helps the patient visualize what their breasts will look like with a specific sized implant. It also gives them a sense of the volume that will sit on their chest wall and how it feels.
The 3D Vectra imaging system is a relatively new technology that’s extremely helpful for determining breast size.This system allows a patient to visualize different sized implants on their actual body.Patients find this to be extremely helpful.
The ability to visualize your projected result alleviates much of the anxiety associated with this procedure.We feel that both the use of external silicone sizers and the 3D Vectra system accomplish this goal.Hopefully this approach can alleviate your anxiety about being too big following breast augmentation surgery.

Choosing Your Breast Implant Size

Choosing the size of your breast implants is the most emotional part of the decision making process. My goal is to achieve a look that makes you feel comfortable. This of course, is different for each individual. The size of the implant should relatively match the width of your breast. An implant that is too large or too small for your chest can lead to long-term complications. Depend on your surgeon’s expertise to determine what size would fit best to achieve your desired look. Ideally, find a surgeon that provides a sizing test during your consultation so you can see your potential result in the mirror. This will provide the most accurate representation of your look after surgery. Please keep in mind when surgeons reference breast implant sizes, they use ccs rather than cup size as a measurement tool. Cup size may vary from bra company to bra company and therefore is not an accurate way to measure breast volume. I always tell my patients that I can get your cup size right and your look wrong and you will be unhappy. But if I get your look right and your cup size wrong you will most likely be thrilled.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.5 out of 5 stars 12 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.