I'm due to have Sientra silicone implants later this month, but I can't decide which size is best: 410cc or 440cc?

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 sizer, and recently, the Vectra 3D
computer imaging system.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.It’s
also important to realize that for many patients, a 30cc difference in breast
size would be difficult to notice.In
reality, a 30cc difference is less than two tablespoons which is spread out in
three dimensions over the implant.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.

This is a small amount of volume and it probably will not matter much.  However, there are formulas with picks the best type of implant and size based on your breast base width, sternal notch to nipple and nipple to the bottom crease of the breast. Your PS probably did this.  Goood luck.

You are talking about two tablespoons or a shot glass  in an implant that is fairly large.  it is a minor amount .  Decide if you would rather be minimally larger or not and pick one. I wouldn't worry about very much. you'll do well either way

Hi L,The difference you are concerned about is just under a shot-glass.  However, most women, in my practice, wish they were bigger a year later.  So, keep that in mind when you are on the fence. I would recommend you also revisit the PS's office, and have the staff help you with our final decision.  You are not alone, as this is a tough decision, and many, many patients agonize over small size differences.  I already know you are in the good hands of a board certified plastic surgeon, because Sientra limits their product to BC PS, exclusively.Since you have two weeks to go, here are some tips and tricks we use to help our patients out.  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.Multiple measurements need to be taken to fit an
implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since
silicone implants wrinkle less than saline implants, they might be your best
bet.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.Be sure to see only a board certified
plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a
member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a
member of ASPS (The American Society of Plastic Surgeons). I wish you all the very best for your upcoming surgery, “Dr. Joe”

if you added 2 tablespoons of volume to your breasts right now, do you think you could see the difference?'In case you weren't sure of the answer, it is NO WAY!So,if you're worried that 410cc may be too small, choose the 440cc implants. My only concern is that since 440cc is only 2 tablespoons larger, if you are "too small" with 410cc implants, then you may still be "too small" with 440cc implants!Try on more implants in your bra and stretchy top and don't look at the sizes--just look at how your chest appears to you. Size issues are the most common reason for re-operation; this occurs more frequently than bleeding, capsular contracture, malposition, or any other "complication." So choose carefully, and call your surgeon's office for help; even if your surgeon is out of town, his staff is there to help! Best wishes! Dr. Tholen