I am confused about the difference in size between 355cc and 385cc. Would there be a bigger risk if going with 385cc?

Hi jaydenmama,
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. 

The two main types of implants are silicone and saline. The shell of the implants can be either textured (which reduces capsular contracture) or smooth. A textured implant sometimes requires a larger incision. The shape of the implant can be either round or tear drop shaped (gummy bear). Both have their advantages and disadvantages.

The different types of implant offer different pros and cons. For instance, the pros of silicone implants are that they look and feel more natural and ripple less.

On the other hand, the pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted, and they can be used for women less than 22 years of age.

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, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

It's really a matter of personal preference.  The difference of 30 cc's is very slight and I don't think too large in general.

The difference between 355 and 385 is very minimal. Whats more important is that the implants were based on your chest dimensions. Once the range of size is ok, sizers can help.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

While the difference between 355 cc's and 385 cc's is subtle, if you have little breast tissue then pushing the volume with the larger size could be a problem; on the other hand, going a little larger is usually what most patients are happy with in the long run. If you have any laxity of the skin envelope of the breasts after your pregnancies then larger might be better. 

30 cc is the increment the average person can detect with breast implants. This is a subtle change and usually most noticeable in the region above the areola. I would not agonize over this decision. I have my patients bring photos of breasts they like in a profile position to see how full the upper pole of the breast is. This is a nice way to understand their desired breast aesthetic. Communication with your surgeon is key. In surgery you can be sat up and the breast visualized. Your surgeon should then be able to chose between the 355 and the 385 based on your appearance at that moment and your communicated desire.As previously mentioned the difference is not very dramatic and you will most likely be thrilled either way.Good luck and I hope this was helpful.

There are a lot of things to consider when choosing an implant size for a secondary augmentation surgery.  The most important question is how happy with your size originally?  Did you feel you were too big or maybe you would have like to be bigger.  The one good thing about your situation is that you now have the opportunity to get closer to the right size for you.  355cc and 385 aren't that much different so you probably won't go wrong either way.  I'm actually glad you chose the 385s because the on disappointment we hear as plastic surgeons after breast augmentation is that the patient wished they'd chosen the larger size.

You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile. Ultimately, careful communication of your goals will be critical.
Generally speaking, the best online advice I can give to ladies who are considering revisionary 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 "C or D cup” or "bit fuller" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
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). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Don't worry about the number of ccs. Have your surgeon find the dimensions of your current implant, both diameter and projection, and then find the Sientra implant that matches those dimensions or bigger or smaller depending on your preference.