Will 385cc sientra moderate plus be too big on my frame for my goals? (photos)

Great question--you should not go into a breast augmentation surgery uncertain about your sizing. How it will look on your frame depends on your measurements relative to the implant. Helpful ways to understand your size and shape goals would be to use goal photographs that show the look you would like to achieve. Another helpful technique I use is to have patients use sizing molds in a bra to be able to "try on" different sizes and see how they like the look and feel of a size on their own body.

I would recommend seeing a plastic surgeon who uses tissue based planning. This involves letting your breast measurements determine the size, much like sizing a foot for a shoe. You are very small and very thin so you need a true expert to plan this surgery.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. 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 size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hello, thank you for your question. That is great to hear. So when it comes to implant size we take measures of the patients chest wall with so although you have a thin frame you can still have a wider chest. I would bring in wish pics of someone you think is similar to your frame and how big they look. You maybe surprised to find out the breast implant size. Also consider filling up two bags of rice and wearing it in your bra to get a better sense of the size. It can be a difficult choice to make but most of our patients usually wish they went bigger. For more information and before and afters check our our webpage. Happy Holidays.

Dear Rational889953,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question and photos. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (250 versus 350), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. The 385 Sientra you mentioned may well “fit” your breast, but the volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a very thin lean frame will require a narrower diameter implant than a patient with a broader chest or larger frame. Other considerations such as saline versus silicone are also important, along with consideration of softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with precise measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide for us before and during surgery. This algorithm which we have been employing for over thirty years has proven to be very successful.

It is crucial that you go back to your plastic surgeon to ensure that you are confident about your and his of her decision regarding implant selection. Make sure your plastic surgeon is experienced, board certified, and that his or her aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Thank you for sharing your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend continuing to discuss your concerns with your plastic surgeon or seek additional consultations to ensure that the implants you decide upon are the right ones to meet your expectations. Best wishes!

Hard to say without an inperson exam but based on your pictures i would look at small gummy bear implants… in the 240-295 range. You are small. Best to try on sizes in the doctors office and see what looks good to you. You should do very well. Best to see a board certified plastic surgeon.
Good Luck!

Andrew Cohen, MD

Implant size is a complex process and is best done in person. Many surgeons have sample implants you can "try on" to get a feel for how you may look after surgery. The implant you are considering should look nice on you, but it may be an adjustment for you as you are used to seeing a tall lean frame with little breast tissue.

Based on the nicely posted photos you might be better served doing 2 separate surgeries. I start with tissue expanders to stretch your very tight breasts skin, After 3-6 months of slowly inflation to attain more skin/breasts tissue volume then round 2 surgery remove expanders replace with implants. Fees from $12-20,000..