I'm 5'10", 140 lbs, active runner, 39 yrs old, and 34B. What size of Sientra Breast Implants do I need? (photos)

I'm going with gummy bear implants. I want a very natural look. I don't like the rounded look. I tried on 275cc to 300 cc at my consult. However after having done some research I feel that I want more, but I want to look proportional for my body. I'm a runner so thus plays into my decision. Pre-op on Wed. I'm going to leave it up to the surgeon, she said she would test out. Question is 400cc to much to fit? I haven't discussed about this size yet. Initial consult was a bit overwhelming! Thanks!

Doctor Answers 22

Chosing a Sientra Breast Implant Size

First, let me say that you are choosing a very good breast implant.  Sientra has great  breast implants. 

At my office we first measure your chest dimensions.  This gives us an idea of what diameter of implant to use.  We then have you try on implants in a tight fitting sports bra.  This mimics an implant under your skin.  Once we have an idea of what size range you like, we pick an implant size and dimension that works for your body size and your likes. 

With the information you have given us, you should get a very nice result with that size implant.  Many patients fuss over a 30 to 40 cc difference but remember that that represents just 2 tablespoons.

I have added a video and web reference for more information for you.

I hope that helps.

Best regards.


Kirkland Plastic Surgeon
4.9 out of 5 stars 56 reviews

A modest implant size may best suit your active lifestyle.

Women with an active lifestyle generally benefit the most from modestly sized implants that can enhance their natural curves without limiting lifestyle and exercise. Your implant size is best determined by a board certified plastic surgeon during an in-person consultation, since many other factors need to be taken into consideration, including your chest width, pre-operative breast size and your goal appearance. I recommend discussing your concerns with your surgeon and showing him or her photos of your ideal breast appearance to help determine the best implant volume for you.

3D Imaging May Be Helpful

The question of breast implant size is always difficult for prospective breast augmentation patients. For this reason, multiple approaches are utilized to make this determination pre-operatively.These include reviewing magazine photographs, external silicone sizers and recently the 3D Vectra computer imaging program to name a few.
Even when tremendous care is taken pre-operatively to determine breast size, the final decision needs to be made in the operating room by the surgeon.At this point, an assessment can be made regarding how the patients’ breast tissue interacts with the breast implant.Occasionally, obtaining a specific size doesn’t allow the surgeon to meet the patients other aesthetic goals.For this reason, locking into a specific size isn’t always a good idea.Results are often better when a surgeon has the ability to make adjustments in the operating room.
In your case, I think it’s important to thoroughly discuss your aesthetic goals with your surgeon.Make sure he has the latitude to do what’s best for you in the operating room so he can meet your aesthetic goals.It’s important that you have an approximate idea of the breast implant size that you’re considering, but don’t become married to an absolute number.

What size should I get?

Looking at your photos, and your height and weight, I think you will need to have a little more than modest augmentation since your nipple level is a little low.  However, from 275 cc to 400 cc range, I think you will look great.  It's all depend on your preference.  I personally prefer round implants under muscle, but Sientra implants are also good implants.  My guess is 400 cc will give you a C/D cup.

Alex Kim, MD
Beverly Hills Plastic Surgeon
4.6 out of 5 stars 22 reviews

What size

I think if it is a round implant you will have a fuller upper part to the breast and it can look a bit larger, while a shaped implant will have less up top and more down low, a more sloped breast and then you do not have the rounded upper pole look. Without having your breast dimensions, feeling the integrity of the skin and seeing if there is a slope to your ribcage, it is difficult to guess but I think the pictures you show as a desired appearance will likely need 300 or a bit more.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Breast implant sizing--some suggestions.

Choosing breast implant size can be done in a number of ways; using as many of them as possible only increases the information I utilize to most accurately achieve the “look” each patient desires.

Of course, patients often have input from friends who have undergone this operation, have a "great result," and have ____cc implants. "Get those!" she tells you. But you probably don’t know what proportion of her present size is her natural breast tissue, and how much is implant. Unless your breasts exactly match your friend's pre-operative breast size (doubtful), and the rest of your chest wall, breast base, and anatomy are the same (impossible, unless she is your identical twin sister), you will need different implants added to your own tissue to get similar results. Determining what size is best for you is even more difficult if you rely on friends who advise to “not go too large” or you will “look fat,” be top-heavy, or have a "porn-star look." Compared to whom? Or is she just a bit jealous? I have seen entertainers, models, and everyday women with breasts of all sizes and shapes--many of whom ask me to give them something different: bigger, smaller, higher, or with an improved shape. What is best for one is definitely not best for all.

Breast augmentation is a personal choice, and while a friend’s input can be helpful, you should choose a size that makes you feel good about yourself. For MOST women, the size you choose is not only possible, but perfect for you! Remember, you should never have surgery to please someone else, or to try to conform to someone else's opinion.

Plastic surgeons that perform lots of breast enlargements have extensive experience in helping our patients choose implant sizes that are compatible with individual anatomy. Every one of us does this slightly differently, and some surgeons even decide for their patient. But what about the patient's wishes? Every patient has a "perfect size" in her mind's eye, and all we need to do is figure out what that size is, and whether or not it will match appropriately with the patient's chest and breast base dimensions, skin and muscle capacity, position of the nipple-areola complex, as well as a host of individual anatomic factors. I start with breast examination, careful measurements (everyone is asymmetrical), and ask you what your goals are. Based on these factors, I can determine if your requests can be achieved. For most patients, the answer is YES! If not, I will tell you, and we try to figure out what CAN work, and how to best get CLOSE to your ideals.

One of the best techniques for choosing implant size is for the patient to bring photographs of models with the desired (final) breast size to their consultation, or at the time of surgery. The proper size implant to most closely achieve this appearance is then chosen in the operating room. (Since we stock all sizes and profiles of saline and silicone gel breast implants in our surgical center, we do not have to “order in advance” and can change based on your choices right up to the time of surgery). Photographic examples have proven to be much more accurate than the patient requesting a letter cup size, or trying to find a similar person via internet search whose anatomy and/or results approximate your goals. Don't try to match your height, weight, or preoperative breast appearance to the photos, and don't use a stated implant size as a guideline for choosing your implant size—just find an “AFTER” photo you like.

Also, if your breast sizes don’t match (most women have some degree of asymmetry), we can choose different implant sizes and/or profiles to achieve as much symmetry as possible. In more severe cases, we can recommend appropriate procedures (such as breast reduction, breast lift, or other surgical options) to optimize size, shape, and position between mismatched breasts. Implant choices can be made to help camouflage chest wall or other skeletal asymmetries caused by scoliosis, pectus excavatum, or certain genetic syndromes.

Trying on implants in a brassiere is another excellent way to provide some idea of desired final breast size and the implant volume needed to achieve that size; however, it is essential not to become overly attached to a specific bra cup size (B, C, D, etc.) or implant volume (400cc, etc.), since the implant size you like in a bra or top will always look smaller when it is under your own breast tissues and chest muscle. Typically, a woman who chooses a specific cc volume implant that she feels looks good in her bra will be disappointed (too small) after surgery if that exact volume implant is used in her body. A good general rule of thumb is to add 50 to 100cc to the implant volume you feel looks good if you choose to size in a brassiere. In other words, if you like how a 400cc implant looks in a bra, it will take a 450-500cc implant to look about the same size in your body.

In general, for an “average” height and weight woman, 250cc equals about one bra cup size. A 12 ounce can of soda = 360cc. Most patients cannot even see a difference of 50cc (3 tablespoons and 1 teaspoon). Thus, 400cc implants will cause an increase of about 1½ cup sizes to whatever breast volume the patient started with.

You are tall, and can likely accommodate 400cc implants quite nicely, and with an appearance that approximates your goal photos. Your surgeon has experience, but you are the person who will live with these implants, so do not "leave it up to the surgeon." You should both work together to achieve the best outcome possible, and with the size you find perfect. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 239 reviews

Sientra Breast Implants

Hi RunMama,
I know you are seeing a board certified plastic surgeon because Sientra only sells to BC PS.  You are tall, so from that standpoint, you can carry a larger implant.  But this is a hard decision.  You are not alone! This is perhaps the hardest decision for a patient to make, as well as the surgeon. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc. You can try on implants in the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the final volume to account for flattening of the implant in the partial submuscular pocket. Once you decide on a size you like, then add on about 25-50 cc, because in real life the implant will be flattened slightly by your tissues.

You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and see what you think.Implant size must square with assessments of tissue cover, breast diameter, and chest wall width. Multiple measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of much discussion.

Therefore, I use a wide variety of methods, but the implant size is always established preoperatively.Also, patients are advised to bring reference photos demonstrating their ideal size and shape. A photo album of patient pictures is maintained to assist them. These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery. In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover. Then, the patient’s verbal requests are factored into the analysis.
All the best, "Dr. Joe"

Best size sientra shaped implant for an athletic patient

best size sientra shaped implant for an athletic patient
300 may be slightly small but 400 will be too large for your comfort

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Sientra Sizing

Choosing a sizing can be one of the most challenging decisions of the breast augmentation process. During the consult your plastic surgeon chooses a range of sizes based off of your height, weight and the width of your chest. These measurements will help keep your augmentation proportional to the rest of your frame. The best advice we give our patients is to trust your emotional response to the sizing test. If you are trying on an implant sizer that looks too big or too small for your frame, chances are the implant will look the same way after your augmentation. The sizing test is meant to give you the most accurate sense of size.Good luck and trust your instincts.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 20 reviews

Implant size

You need an in person evaluation by an experienced board certified plastic surgeon to determine what size implant is best for you. Remember that the size of the implant is one of many variables to determine and account for to give you the results you desire.

As you stated, the first consultation can be overwhelming. I recommend that you have as many pre operative visits with your plastic surgeon to discuss all of your questions and concerns.

Best Regards,
Dr. Stutman

Ross Stutman, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.