Age 35 years old, 5'3, 133lb,32/34a. I chose a 495cc HP sientra implant - Is it too big? (photos)

Although 495cc sounds large, it is likely the right size for your breasts if your BWD is 13cm. Your surgeon should be able to get you a sizing session with implant sizers prior to your procedure. While this can be misleading when a breast lift is involved, it should not affect your sizing because your nipple do not need to be lifted all that much. Your breasts are overall symmetric, however there is some slight nipple asymmetry and a lift will certainly help to even this out.

Dear KelSs0426,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

It's difficult to recommend a specific implant for you without knowing more about your surgical goals. A 495cc HP implant will increase your volume multiple cup sizes and give you more upper pole fullness. Many surgeons have sample implants you can "try on" to get a feel for how you may look after surgery. I've included a video on implant selection that I hope you find helpful.