How many CCs would you give me to help reach my goal? (Photo)

Question

The gray bra is me trying on the 350 mod profile sizers which I think look too small compared to my goal pics. I want sientra 107s in high profile. My BWD is 12.5-13cm. Do you think 415-440ccs hp would be appropriate in this case?

Carlos Marciales, MD · Answer

Yes 440 cc will be the appropriate for your case to achieve the gold of the pictures, sientra it’s a good brand !!

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.
With regards to your specific question, your choices seem reasonable. While impossible to be entirely certain, achieving the looks in your Goal Photos may require something larger. Making a comparison requires an understanding of where they started.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Donald Groves, MD · Answer

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

Daniel Barrett, MD · Answer

Dear RealSelfMember0998938,
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

George Volpe, MD · Answer

It is hard to answer this question without knowing more about the patient, for example height and weight. The photos of models show quite full breasts with significant fullness in the upper part of the breasts. Implants in the 400's can certainly give a look like this in a smaller framed individual but it also depends on pre-existing breast volume. If the individual is larger framed, a larger implant may be necessary if the 1st pictured model is the goal. Given the significant superior fullness, a moderate profile implant may not yield that result and a higher profile may be indicated. Choosing a profile can sometimes be difficult, for example mentor has about 7 different profile shapes for a given size. A moderate profile implant will give significant width to the breast but may not achieve the superior roundness seen in the model photographs. It is more likely to be teardrop shaped versus other profiles, for example the mentor SMHX type implant or certain Sientra's as noted. The cleavage in the 2nd middle photograph shows to breasts touching. This is a very difficult result to achieve depending on one's starting anatomy. A good discussion with your surgeon

David Hill, MD · Answer

You should bring these goal photos to your surgeon for consultation. While there is rarely an exact number of ccs that get an exact result finding a sizer that is closer to your goal size is a good starting point. I personally often will order several sizes of implant to get closest to the patient's goal in the operating room. Having reference photos like these that are all similar to your own chest width and all similar in breast size is an excellent way to start and make sure that you and your surgeon are on the same page.

Azita Madjidi, MD, MS, FACS · Answer

Sientra has declared bankruptcy. To have your answer, you will need to be measured by your board certified plastic surgeon for your breast width and only then, you can chose the projection that will give you the shape you like, which seems to be a High Profile.

Jed H. Horowitz, MD, FACS · Answer

Real self  breast implant size

Breast implant size: choosing the correct volume

There are a number of ways to help select the correct implant size. Using photos of patients who have a similar. Height and weight are helpful. It is also important to consider. The diameter of the breast implant. The projection. The amount of. Side breast. And cleavage that you desire. Implants of the same volume. The idea of base diameters and projection. Choosing the correct implant. Will help you achieve your desired goal.

it ia possible to use breast implat sizers. Or methods such as. The rice test. Where? A plastic bag is filled with rice or water. Of the desired volume. And placed in a bar of the desired size.

Breast implants come in a variety of shapes, sizes, and profiles in order to offer a custom-fit and natural-looking physique. It is also important to consider the substance and texture of an implant. In particular, those implants approved by the U.S. Food and Drug Administration (FDA) are filled with silicone or saline. These materials impact the feel and look of a breast implant, and thus are an important consideration in determining the desired appearance of your breasts.

According to studies, more than 90% of women are satisfied with the results of a breast augmentation. This is largely because the procedure often improves a woman’s self-esteem, not to mention quality of life. We aim to custom-tailor your breast augmentation based on your preferences for perkiness, firmness, shape, and size. Our goal is to match the appropriate implant type with the right procedure so that you are completely satisfied.

Breast augmentation will enhance the shape of your breasts as well make them fuller. You may find yourself more comfortable wearing different types of clothing and may enjoy a boost in self-confidence, as is the case with many happy patients.

Gianfranco Frojo, MD · Answer

I would see a surgeon who has preoperative 3D imaging capability. This will hep alleviate any of the confusion around sizing.

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 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 is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

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