I'm due to have Sientra silicone implants later this month, but I can't decide which size is best: 410cc or 440cc?

Hi L,The difference you are concerned about is just under a shot-glass.  However, most women, in my practice, wish they were bigger a year later.  So, keep that in mind when you are on the fence. I would recommend you also revisit the PS's office, and have the staff help you with our final decision.  You are not alone, as this is a tough decision, and many, many patients agonize over small size differences.  I already know you are in the good hands of a board certified plastic surgeon, because Sientra limits their product to BC PS, exclusively.Since you have two weeks to go, here are some tips and tricks we use to help our patients out.  Cup size
estimates can be misleading, but I generally advise patients that they will
experience an increase of approximately one cup size per 200 cc. You can try on
implants in the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the
final volume to account for flattening of the implant in the partial
submuscular pocket. Once you decide on a size you like, then add on about 25-50
cc, because in real life the implant will be flattened slightly by your
tissues.Multiple measurements need to be taken to fit an
implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since
silicone implants wrinkle less than saline implants, they might be your best
bet.You can also approximate this at home by
measuring out an equivalent amount of rice placed into a cutoff foot of old
panty-hose, and put this in your bra.Wear this around the house for a while, and see what you think.Implant size must square with assessments of
tissue cover, breast diameter, and chest wall width. Multiple
measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of
much discussion. Therefore, I use a wide variety of
methods, but the implant size is always established preoperatively.Also, patients are advised to bring reference
photos demonstrating their ideal size and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in
determining where the implants will be placed, since they can be shifted inside
(to provide more cleavage), to the outside, up or superiorly, and down or
inferiorly during surgery. In determining the final size selection, I always
place the highest priority on the preoperative measurements and potential
tissue cover. Then, the patient’s verbal requests are factored into the
analysis.Be sure to see only a board certified
plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a
member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a
member of ASPS (The American Society of Plastic Surgeons). I wish you all the very best for your upcoming surgery, “Dr. Joe”

Unfortunately you cannot order the exact volume you wish for - however I would not be concerned. If you are happy with 440 it is likely you will be happy with 410cc - it really is a minimal difference. It is highly unlikely you will notice the difference of 30cc. Often surgeons will order or have available both sizes so you can choose on the day if needed. You should let your PS know your concerns so they can both be ordered. If you feel that 440 isn't sufficient then this is more of a concern and you would need to consult with your PS again. It does not sound like this is the case and I am sure you will be happy with the result.