Are 525 cc moderate profile Sientra cohesive silicone gel implants too big?

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

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Based on your height and weight 525 cc sounds like a large implant. I would have consultations with additional surgeons to hear their recommendations. Overly large implants not only create an unnatural appearance, they also thin the skin and breast tissue with time. Appropriately sized implants are meant to give a great look, and also preserve your natural tissues.

Dear bevfong94,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, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

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?
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 "natural 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. 

Your breast width will be the primary determinant of the range of breast implants that would be appropriate for your body.  A 525 cc moderate profile implant does sound quite large for a typical patient who is 5'1 and 114-118 lbs.  The breast width on that implant is 13.8 cm, which means your breast width should be at least 14 cm or more, which is quite wide.  If you want an implant in the 500 cc range and have a narrower breast width than 14 cm, you may consider choosing a high profile implant.  Otherwise, consider using a smaller implant, as you suggested.  In our practice, we use Vectra 3D imaging for preoperative planning.  This simulation allows you try each implant size on your body from different angles to pick the implant size and shape you like most.  This has helped ensure the greatest possible patient satisfaction after surgery.  Best of luck.
Ziyad Hammoudeh, MD   

At 5'1" you are very petite. I have to say I am surprised that a female surgeon would make that recommendation. Unfortunately there seems to be a perception among patients (not necessarily you) that you can keep going larger and larger and keep getting the same quality of results, just larger.  This is absolutely not true.  Many studies show that going larger than 350 cc's leads greater and greater chances of complications and need for reoperation.  I have always felt that a pretty breast is more important than sheer size, and that striving for long-lasting results is also important.  The larger you go, the thinner the tissues become.  They are then weaker, sag more quickly, show veins and ripples more, and with large implants even the ribs can become indented (which is permanent).  The other issue is that moderate profile implants are wide, and unless you have a very broad chest for your size, these in a 525 would tend to create unnatural upper breast fullness as well as having them go too far to the sides.  I would rethink the size.  What would be more helpful is for you to bring in photos for your surgeon to see as to your desired results and also have you try on sizers meant for breast augmentation patients.  Good luck!

It is always difficult to be an armchair quarterback and say whether an implant is too big or an appopriate size without an examination. The implant size is determined by a number of anatomic factors including tissue looseness, breast diameter, and tissue thickness. Certainly more than one consultation is always a good idea, and this can alleviate your concern.
Sincerely,
Thomas C. Wiener, MD
Houston
this information is not a substitute for a consultation with a board certified plastic surgeon.

Breast augmentation  requires finding the right implant for the right patient based on their desires and their anatomy. For most patients with your height and weight, 525 cc implants would be far too large. But none of us have the advantage of having examined you. If you're not comfortable with your doctors decision, you need to meet with her again or find another consultant  

IMO you would need to have significant skin relaxation with good breast aesthetics to accept such a large implant and yet look natural.  In general I would be planning to select from a range of smaller implants during the surgical procedure through the use of test implants.  I feel that an excessively large implant may look good in the short term but the added weight and stretch on your tissues from a large implant often takes a toll in general.The video link below will explain how I make my final implant selection during the surgical procedure based on actual results as shown through the use of test implants called sizers.If you have any doubts, consider getting a second opinion from another surgeon until you are comfortable with your selection.  Best wishes,
Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Member, ASAPS, ASPS

Extreme Makeover Surgeon, ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca