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 (22)

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 40 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 23 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 46 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 718 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 54 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 19 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 40 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 12 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 17 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 19 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.