What size will I end up going from 34A with 350cc Sientra classic anatomical shape? (Photo)

At the time your photos were taken, you showed very little post-op swelling, virtually no bruising, and good implant position (important for textured implants, which cannot be expected to drop, soften, and settle like smooth round implants). All of this is good, indicative of excellent surgery, and usually predictive of superior outcomes.By now you already know that much of your surgical swelling has gone down, and since your implants neither swell nor go down in size, your present size is very close to what you can expect long term.For other readers, surgical swelling reaches its peak 3-5 days after surgery, and then starts to diminish over many months, with the most rapid changes in the first few weeks. Of course, menstrual cycles, salt intake, and other factors can influence the degree of swelling in individual patients. Of even more significance is the technical skill and tissue handling precision of your surgeon.Careful dissection, precise hemostasis, and delicate tissue handling are hallmarks of excellent surgical technique, and I believe this is an integral part of good surgical outcomes. Blunt dissection, lots of bruising and swelling, use of surgical drains, Ace bandages, or surgical bras may indicate less gentle surgical technique, and can be associated with higher risk of capsular contracture, hematoma requiring re-operation, and less ideal outcomes.To be fair, surgeons who are in the latter category are not willfully chancing your results; they simply were trained that way, have not seen the benefits of spending a tiny bit more time and care in the operating room, and are generally accepting of whatever outcomes (still usually satisfactory) they achieve.Those of us who have adopted more careful and precise surgical techniques have seen reduction of complications, improved outcomes, reduced re-operations, and happier patients. Some of these enlightened surgeons have even suggested that their techniques are worthy of "special names" to imply they are the only plastic surgeons capable of "overnight recovery," "Flash recovery," or "Super-duper heal in one weekend breast augmentation." (Well, not really the latter, but you know what I mean.) Remember, there is nothing special or proprietary about good surgical technique, and physiologic healing takes the same time for all patients in good health and nutrition states. Yet, knowing your surgeon takes the care and time to "do it right" rather than regarding your surgery as "Yawn, just another boob job" is a vital thing to know, especially before you choose your surgeon.It certainly appears as if your surgeon is in the "takes good care" group. You should see very little change from what you see now in terms of size, just improved softness and more sensation return as you heal and your scars fade. Congratulations to you, AND your surgeon! Cheers! Dr. Tholen

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

The most important thing is what you have already said " I love them". That being said here is some general information on how to pick the implants that are "just right". It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.