A cup hoping to achieve a small B, would 140 Sientra moderate or 200 to 230 Natrelle high profile be the better option? (photos)

Bra sizing varies from company to company with VS often making people seem to have larger cup sizes. Also, a B for someone who is very slender is much less volume than someone who is significantly larger.
What you should do is go to ricetest.com and perform the rice test with all your favorite outfits to determine what additional volume will give you the look you are hoping for. Once you get this number your surgeon should be able to measure your breast base width to find an implant that will fit your body well and give you the volume you are looking for.
Remember, figure out what volume looks the way you want it to in clothing, don't try to go for a certain cup size.
Hope this helps!

I'd suggest using 3D breast implant imaging. The technology can be used to show the exact implant volume and profile so you can see what each one looks like.

Dear Calm741761,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

That's a pretty big spread, almost 70 percent difference in proposed sizes. Did anyone size you, or did they come up with those numbers in their heads? If the answer is the latter, then you need to see a surgeon who performs either 3D photo simulation or in office sizing with purpose built sizers (my preference). Using these techniques drastically reduces 'wrong size surgery', a very distressing situation where a potentially perfect surgery leads to a VERY unhappy patient who feels she got the wrong size. Don't leave it to guess work, even with the 'experts'. Talking about desired cup sizes or showing your surgeon photos of other people does little to reduce your risk of wrong size surgery or replace proper implant selection techniques.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hey, thank you for your question. Based on the photo and your description, I would not recommend a high profile implant. I think a HP implant will be too narrow. I would recommend a moderate plus or a low plus profile implant. I would want to get you into the office to do an exam, review goal photos, and to use virtual sizing technology to give show you how each implant size is likely to look on you and to finalize and size and profile from there. Hope that helps!

First choose the volume you want. the profile is then selected based on your measurements. Your surgeon can help guide you with this. I think the 200-230 cc volume would look very nice. Try on both volumes and see what you like. You might even select 175 cc's.

Profile of implant refers to how much the implant projects from the body. Typically the lower the profile, the more natural the look. You may also consider having the implant placed under the muscle as that tends to provide a less "fake" or obvious look. Many surgeons have sample implants available that you can "try on" to give you a feel for how you may look after surgery.

Outcomes for breast implant augmentation are primarily dependent on the patients candidacy for the procedure, how the procedure is performed and the choice of implants.
Each plastic surgeon has their own way of determining what implant type, size and shape is most appropriate. Generally speaking the decision is usually first made by determining the correct diameter implant then choosing the profile based on how large the final outcome should be. Generally speaking lower profile implants look more natural as do smaller implants,
If 90% of a woman’s breast is implant then her breast is going to look more like an implant and less like a natural breast.
A lot of women get used to the augmentation soon after surgery and often regret not going bigger. When women know they don’t want big breasts they usually mean it. This is often true for women who are a little more mature compared to younger women. These are generalizations and may or may not apply to you.
In your case I think a lower profile implant with the correct diameter would be better.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before abd after pictures of previous patients who look just like you in the before pictures. You can then see first hand what results look good to you and the doctor can confirm what implants were used.
An experienced surgeon should have hundreds or even thousands of before and after pictures to choose from.
An experienced surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Peoples candidacy for breast augmentation vary significantly from one person to another. Things that may lower somebody’s candidacy include variables, like having diverted nipples, and other issues that are not corrected using breast implants. From that perspective, you seem like a good candidate, and should expect quality outcomes.
Being shown a handful of preselected pictures representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the the hands of each provider or how many of these procedures they’ve actually performed. It’s also important to ask you to provide her with their most common revisions are, what the revision rates are, and what they were revision policy is.
Sufficiently talented and experienced plastic surgeon should be able to guide you through the implant choice selection without leaving you wondering if you’re making the correct decision.
Best,
Mats Hagstrom, MD