Please help me decide on an implant size Sientra 385 or 410 mods ? Surgery in two weeks (Photo)

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

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below reference.

Get as much insight as you can from your plastic surgeon. Then, go with your whim! The differences between these implants are so small you probably would barely notice the difference. It is an interesting exercise to micromanage these decisions, but you would probably be exceedingly happy with either implant. In fact, you may just be one of the 90+ percent of  who say they should of gone just a little bigger.

A few rules of thumb about breast implant size: 1. The implant cannot be wider than the existing width of the breast, an needs to be a little bit narrower because the measured width is external (so a 13 cm width implant in a 13 cm wide breast may not be a good idea); 2. Most patients would choose to go a little bit larger if they had to do it all over again; 3. a 25 cc difference is less than 2 tablespoons, not very significant; 4. work with your plastic surgeon and rely on their experience and expertise to guide you. Your breasts appear to have a slightly oval base, which means the vertical diameter is less than the horizontal, which in turn means the wider implant could be problematic. Everything involves trade-offs.

The difference between these two implant sizes is small. I suggest you go with the bigger implant if your PS thinks your body can handle it. Good luck and be well.

I do understand your desire to have it perfect but 25 cc's is not worth worrying about and its really insignificant in your outcome.  Look at the dimensions of the different implants and you're talking a mm change.  Most of my patients always regret that they didn't go larger.  So I always advise my patients to always go with the larger one if they like the look of both.  And no one has ever regretted that.

Thank you for the question.  Despite your good description of goals, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical. Given that your surgery is coming up soon, I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, preferably prior to the date of surgery.
Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) 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 are 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 or small D cup” 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.  Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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,  after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast  augmentation surgery concerns) helps. Best wishes. 

You are deciding between two implants that are less than one ounce different.  Equally the diameters are very close. You can use a ruler and actually draw them out.  Your surgeon will be the best person to advice you, not online consultants. Best wishes. 

One implant size difference in general does not make any visible difference to your shape, size, etc. I would recommend following up with your surgeon to make such fine adjustments.

The difference of 25 cc is so small, that it is really insignificant.  Trust your surgeon to guide you in the right direction.