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.

Thank you for your photographs. Your breast width is 13 cm but you did not include the distance between your nipple and your inframammary fold under maximal stretch. The breast width, and the distance from your nipple to your inframammary fold will tell you what your skin will naturally accommodate for an implant without violating the normal boundaries of your breast. If you don’t violate the boundaries of your breast, that will give you the most natural looking result. If you choose an implant with dimensions that exceed the normal boundaries of your breast, it can lead to a less natural look and potential problems.

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this:
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you. Also, just FYI, each surgeon's measurements are slightly different, so numbers, experience, and overall aesthetic from one surgeon aren't necessarily the same as those from another surgeon!

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Depending on what aesthetic you are aiming for, that implant size may serve you well. I would certainly question the need for a vertical lift. An implant will not move your nipple position much, but just getting an implant might give you a very nice result. You can always consider a lift later, if appropriate. I am not sure you are even a candidate.

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.