Given your implant options that you mention, you do not have a significant asymmetry. The difference between all three implants is 40 cc, which is less than 3 tablespoons! However, base diameter might be a bit different. Personally, I don't think you'll see a major difference no matter what implant you use. Most women have asymmetries; your breasts are sisters not twins. Perhaps with a photograph, I might be able to give you a better idea. Good luck.

Published on Jul 11, 2012

Ask your surgeon to show you a photograph of what you can expect. Usually, 20cc is not much of a difference.

Published on Jul 11, 2012

I would not despair. In 37 years, I have never met a symmetrical patient, so you can relax. You will do fine.

Published on Jul 11, 2012

We have a unique imaging system that scans your breasts and shows you how your breasts would look with various shapes and sizes.

Published on Jul 11, 2012

Split the difference: 335cc

Published on Jul 11, 2012

You need to communicate your goals with your surgeon.
The use of sizers in your bra preoperatively does not accurately correlate with the size of breasts achieved with sub muscular implants. I think that it is very important that you communicate clearly with your surgeon to maximize the chances of achieving your desired breast size.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

Published on Jul 11, 2012

choosing implants is a personal decision between you and your surgeon. Trying on sizers in your bra often helps give you an idea of how big you want to go and correction of asymmetry. Your surgeon may also use sizers intraop to pick final implants to get you as symmetric as possible

Published on Jul 11, 2012

This is an impossible question to answer without seeing your photos, but I can tell you this- your PS should not be leaving this up to you- they should guide you through this decision process by taking chest measurements, reviewing photos with you of patients with asymmetry who used different size implants, and by working with you with implant sizers in the office. Then in the OR your PS can use sizers to determine the final implant choice. This should not be a guessing game.

Published on Jul 11, 2012

Unfortunately, I can not help you. I don't have photos and I have not examined you, so my recommendation would be a random guess. I can tell you though, that it should not be up to you. In my experience, expert cosmetic breast surgeons do not give you options like this. Their expertise allows them to make the best decision. I don't know who you are seeing, but you should perhaps see a few more surgeons.

Published on Jul 11, 2012

Asymmetric breast is very common and the way that we solve this problem is to use special implant sizers at the time of surgery. We can then select the best combination for you to be as symmetrical as possible. It's sort of like trying on shoes before you buy them. So ideally you can ask your doctor if he/she uses this as part of their surgery procedure to obtain the best possible accuracy. We have found it very helpful.

Published on Jul 11, 2012

You need to know that 35cc are in one ounce. So the additional volume is minimal. I would make that decision on the OR table, by sitting you up and looking. That being said, the breasts are sisters not twins and as a result there is always some asymmetry. One has to consider the rib cage differences, the pect. muscle differences, the breast gland differences and final the skin differences. Without photos and more specifically seeing in person ( which is a three-dimensional evaluation) it is hard to be more specific. Speak with your Board Certified Plastic Surgeon and ask him / her to help you understand why there are differences.

Published on Jul 11, 2012

You can try on sizers in the office and get an idea of what you think would be ideal in terms of sizing. This is probably the best since you personally can determine what feels symmetric to you. Your surgeon can also try on sizers in the operating room but at that point he will be the only person making the assessment of symmetry.

Published on Jul 11, 2012

It really depends on the amount of difference there is between your breasts. You should know that most women to do not have symmetrical breasts. Not only does the volume differ but there are also diffences in fold height, degree of droopiness, nipple position and even chest width between breasts. Some of these differences can be corrected at the time of surgery but some cannot. 20-40cc is not a significant amount of differnce in volume so I assume you have a subtle difference in the size/volume of your breasts. If this is the case then augmenting the smaller breast with a slightly later implant is a reasonable thing to do. One thing to remember is that as the implant volume increases so does it's dimensions, specifically the diameter of the implant increases. This means that the implant is now wider and taller then the smaller implant. These differences can produces noticeable diffences after surgery. That is to say the volumes may be more symmetric but now the breast with the larger implant may have slightly more upper pole fullness or be slighlty wider then the breast with the smaller implant. For this reason, sometimes different cc implants are not the right answer. I am particularly worried about this when I am considering moving up 2 sizes form one breast to the other. I don't mean to confuse you. All in all in sounds like you have a small, normal difference between your breasts and selecting either the same size implants or one size larger for the smaller breast should produce a nice result. Having not seen you I cannot tell you specifically what I would do but hopefully this will give you some insight as to how Plastic Surgeons make decisions on implant sizes. If nothing else remember that no one goes into surgery with perfectly symmetric breasts and therefore they are ulikley to come out of surgery with perfect symmetry. Set your expectations appropriately and you should have a great result that you are happy with.

Published on Jul 11, 2012

Asymmetry is very common with breasts- remember they are sisters not twins! Different sized implants can usually get them very close- but usually not exactly alike. I am concerned that your surgeon is asking you to decide the volume difference- he/she is supposed to be the expert. That being said, a 20cc difference is minimal- that is 1 teaspoon and 1 tablespoon- unless you have very little breast tissue the difference will be very slight.
Ask you surgeon again what they would do in this instance- see if they think that a 20 or 40cc difference is warranted.

Published on Jul 11, 2012

You have given very precise information but it is difficult to say in an online forum without seeing you in person. The volume differences are really quite minimal in most people. Most patients would prefer the larger volume for the effort of surgery to reach a slightly larger enhanced cup size. Talk with your plastic surgeon about his/her philosophy. You sound like you're almost ready to go!

Published on Jul 11, 2012

30 to 50 cc is a noticeable difference that should be identified preoperatively with the decision to correct and how much made intraoperatively by the surgeon. It is important to determine whether asymmetry is caused by breast ptosis (sagging) on one side. A bigger implant does not correct this.

Published on Jul 11, 2012

I would first check to see if the Sientra implants are still available. Secondly this is a very subtle difference. Using sizers may help in the decision making process using implants or the rice test to simulate the different combinations.

Published on Jul 11, 2012