I'm normally a 44 / small 46, but wear a 48 in MA+.
I would never have known that if I hadn't tried one on at H. Lorenzo here in LA first!
48 in MA+ is a perfect fit, and I'm 6', 135 lbs., 30" waist (to give you some idea of my build). In any other designer, I'd be swimming in a 48, but in MA+ it's "just right" snug! Hope that helps!
Also, although yes the sleeves run long, apparently you're supposed to "scrunch up" the sleeves, which is what give that cool "stacked" effect in the elbows, at which point the sleeves ride a bit higher.
Edited by fwoedit - 11/2/14 at 8:03pm