Are 505cc Sientra 106 implants considered large for my frame?

Question

1st BA here - My BWD is 14cm and my surgeon recommends 505cc Sientra 106 implants with a moderate+ profile to achieve my goal photos (34D/34DD). I currently am 34AA/34A with an athletic build but a "wider chest". I am 5'6 and 160lb. I know it is important to not get too fixated on the # as CCs appear differently on everybody. However, to hear 505 as the recommendation came as a shock to me! I have tried on sizers and completed 3D imaging. Are 505s considered large for my frame? Higher risk?

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dallas Buchanan, MD · Answer

Thank you for your questions. Some photos would be helpful for sure. You do have a wide base diameter and could likely support a large implant, but the question is, does that meet your goals? If you are an A cup now, and want to be a D, then that is roughly a 3 cup size change which is going to be likely an implant and in the range of 450-600, so 505 may not be crazy. However, before choosing a large implant like this which can cause significant stress on the soft tissue over time, I would take time to try on implant sizers, use digital 3D modeling (Crisalix), and other methods to make sure this is what you want to achieve your goals. It sounds like you have done all those things, so did all of those point you in the same direction as the 505 implant? If so, then do not worry about the "sound" of the size and accept that this is what it is going to take to achieve your goals. Make sure you are seeing a plastic surgeon who is board certified by the American Board of Plastic Surgery (presuming you are with Sientra implants).

Good luck!

Dallas R. Buchanan, MD, FACS
VIVIFY plastic surgery

Good luck!

Dallas R. Buchanan, MD, FACS 
VIVIFY plastic surgery

Luis A. Mejia, MD · Answer

Dear Dondefleur, thanks for sharing your concerns, I do not recommend that size of implants for your frame, I do rather recommend smaller implants to provide you with a full and marvelous shape, it will be good also to see some pictures, also sizes and positions are a thoughtful decision that must to be talk with your surgeon, you should go to an in person consultation in order to see different sizes and discuss your desired results. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Gary M. Horndeski, MD · Answer

At size 34 A, each 100 cc of implant corresponds to 1 cup size change. 500 cc implants would take you up to a size F. Also, 500 cc implants weigh more than 1 lb each and will not fit submuscular. I would recommend you consider small size implants for long term stability.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear dondefleur,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

The 505 cc implant is a large and heavy implant and is too large for most women. I would try this size on and some smaller so you can actually feel the weight and see the size. Long term, i think you would do better with something smaller.

Ali Gurlek, MD · Answer

Thank you for your Question. 
there are multiple factors influencing the actual size increase a breast implant will provide other than volume, including:
Implant profile (projection) and base widthImplant shape (i.e., classic round, teardrop shaped, extra upper pole fullness)How much natural breast tissue you haveThe width and contour of your rib cage

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