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

Question

I have 300cc saline implants under muscle for 18 yrs. I have capsular contracture Grade II left & Grade III right. Having surgery to have a capsulectomy & replace implants with Sientra Round Textured Silicone under muscle. I want bit fuller & natural looking. PS suggested 355cc (account for loss from capsulectomy & silicone tends to look a bit smaller). I chose 385cc, but worried it m too big? I have little breast tissue. 5'2" 115lbs. had 2 kids since 1st breast aug. Advice pls?

Tom J. Pousti, MD · Answer

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.

Daniel Barrett, MD · Answer

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

Ronald J. Edelson, MD · Answer

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.

Jaime S. Schwartz, MD, FACS · Answer

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

Richard Baxter, MD · Answer

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.

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

Answers (8)

Answer: Implant sizing

Answer: Implant sizing

Answer: 30 cc implant size change = 2 Tablespoons

Answer: 30 cc implant size change = 2 Tablespoons

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

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

Answers (8)

Answer: Implant sizing

Answer: Implant sizing

Answer: 30 cc implant size change = 2 Tablespoons

Answer: 30 cc implant size change = 2 Tablespoons

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.