Should I go with 365cc under muscle or 400cc?

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.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look.
With regards to your specific question, I would not stress over such a small volume differential. 35 cc amounts to 7 teaspoons or less than the volume of a shot glass. It is unlikely to make more than a subtle difference which most would be unable to discern post op.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

The implants are generally shipped overnight by the manufacturer. Your surgeon should be able to change the implant size if there is enough time to do this. The question is also if you should change the size at all. There is not that much difference between 365 and 400 mL. I would recommend the smallest implant that satisfies you need.I always have my patients try on implants externally in a bra and with a T-shirt to decide what size they would like. This gives a very good idea of the size of the breast after surgery. The actual implant that is chosen will also depend on the size of your chest.Good luck.

Dear Kirsty Marie,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hi and thanks for your question. Once the implants are placed under the muscle, can they tend to appear a little smaller. If you desire a larger breast size, you may want to consider using the 400cc implants. The difference between the 360cc and 400cc implants is only 40cc which isn't a drastic difference. I recommend having an additional sizing meeting prior to your surgery to go over what implant is suitable for you. Hope this helps and best of luck.  

This is a difficult decision for many women. I have my patients do the "rice test" to visualize how they will look with different size implants. Of interest, there are more women who wish that they went larger rather than smaller. However, 35cc is less than 2.5 tablespoons. Good luck.

Hello and thank you for your question.   The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Hey there,Size of implants are not absolute which means you may go in for a change in size. Proper and thorough assessment of the breast tissue volume, the base diameter ,thickness of skin is essential .If your breast allows for an easy placement of a 400 cc implant then there is no contraindication whatsoever.
Hope this helps.

It would be difficult to advise without an in-person examination. Usually the implant size is determined by chest wall measurements, skin elasticity, your desired results, and your surgeon's technique. Patients are advised to consider the smallest volume possible which would give the same results with that of a bigger implant. It would be best to have a detailed discussion with your surgeon regarding this as he/she would know best about your conditions and goals.

Greetings Christy, thank you for this query. To answer your question, I would like to give you some a little idea as well as some basic guidelines that will help you understand the answer better. Optimum
size of the breast implant for a long lasting results is decided by individual breast characteristics likebreast with tissues, mass, height and other factors. During examination your cosmetic surgeon willdiscuss with you details regarding the same and guide you on the maximum size possible for you andaccording to your surgeon’s advice you can go for maximum possible implant size below the muscle.Please re-consult with your plastic surgeon and express your views about the 400cc implant and discussabout the possibilities. Best of luck Dr Milan Doshi Mumbai, India.

My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?Practices will vary;  I think that in most practices "changing your mind"  regarding breast implant size should not be problem.   Personally, in my practice, I prefer to have a full range of breast implant sizes/profiles available in the operating room.
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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
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. For example, I have found that the use of words such as “natural” or "C or 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 helps. Best wishes for an outcome that you will be very pleased with.