What size do you think would be a better fit for my body, the 355 or 385cc Sientra Moderate Plus Profile? (Photo)

Question

I'm 5'6" and weigh 132lbs. My breast diameter is 11cm and currently a 34a. I'm looking to a full c. I like running and being active. I don't want to look top heavy but love to get some cleavage.

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

Ira H. Rex III, MD · Answer

The two implants you have chosen are very close in volume and dimension. In reality, it probably doesn't matter which one you go with. You probably shouldn't concentrate so much on cup size, but on the look you are aiming for. I find the best way to do this is using sizers in a sports bra.

Adam J. Oppenheimer, MD, FACS · Answer

If you're on the fence, just go with the slightly bigger size. That said, I'm conservative and you have a small and tight breast skin envelope. I might have offered you a smaller size based on your dimensions, but like i said, i don't like to push things too much. I don't like stretch marks that I caused by using implants that the patient suggested, so I tend to use smaller implants in general than most doctors.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. I think either choice would be a good option for you as there is only a 30cc difference. It is important to clearly convey your desired goals to your plastic surgeon so that he/she can make the appropriate judgement in the operating room. Please see a board certified plastic surgeon who specializes in breast augmentation procedures. Ask to see a lot of before and after photos of their work on women similar to you. Hope this helps and good luck.

Richard Baxter, MD · Answer

Your goal pictures show very full breasts so the simple answer is go with the larger size. On the other hand, for someone who is a runner and doesn't want to look top heavy, the smaller size makes more sense. It will best be decided by trying implants in a bra, ignoring cup size and just seeing what looks right.

Michael Suzman, MD · Answer

Your photos show that your width of the breasts is quite narrow.  To get the most augmentation with a narrow shape using Sientra implants, I would recommend using their anatomic shaped, round base, high profile implant. In patients with your shape, they look fabulous and have a lot of projection.To see how you look, you can use 3-D imaging-- visit a surgeon who uses the crisalix system ( just google crisalix- it is amazing technology.Best of luck in your procedure

Mark P. Solomon, MD · Answer

Your surgeon is the best one to answer this question.  S/he can tell you the exact dimensional difference between these devices.  It is only a few millimeters, so cup size is not likely an issue.  If you really only want a C cup, then you may have a difficult time finding the right implant. Your "wish" photos are much larger than a C cup, which is smaller than you think. I tell patients that surgeons create breasts not bras.  My patients are generally very happy with their results, but their bra sizes will vary depending upon the bra manufacturer and type of bra they choose to wear.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. You have also done a nice job, both in your description and with your goal photographs, communicating your goals here.

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 “very natural” or "full C 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 (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Steven Yarinsky, MD, FACS · Answer

Either implant you have chosen will give you a fine result.  But I have found that women get too obsessed with "bra cup size".  Remember, a C-cup at VS is probably a B-cup at Walmart, and since the bra manufacturers have not standardized cup size, you should concentrate more on the implant size you desire by putting a prefilled gel implant inside your bra.  Since women get very accustomed to their larger breast size after an augmentation, I have found at 6 weeks out when I ask my patients "are you happy with the size you chose?"  50% say yes and 50% wish they had gone a bit larger!  So you can't really go wrong with choosing the slightly larger implant- the 385cc that you are considering.  It is only two tablespoons larger than the smaller implant.  Be sure to put a prefilled gel sizer implant in a bra to choose the size that you want.  And remember, your breasts will look slightly smaller after your augmentation than how they appear with the test implant placed above your breasts in a bra.  Speak with your surgeon about whether a moderate plus profile or higher profile implant will be better to fit your natural chest wall/breast size.  Hope this helps.  Wish you the best result!

What size do you think would be a better fit for my body, the 355 or 385cc Sientra Moderate Plus Profile? (Photo)

Answers (9)

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