Will 450 high profile silicone be able to provide the look I'm hoping for?

I like Dr. Au's answer, and agree with much of what he has to say, especially his last sentence. But I would disagree that 450cc is "too big." And I don't know without exam, but after breastfeeding 3 kids, I suspect your breast skin is not overly taut.You want large, and that is perfectly fine, as long as your anatomy is compatible. Depending on your exact measurements, and your intra-operative pocket diameter, I would choose the lowest profile implants (widest base for a given volume) that will "fit" within your pockets and breast bases. I think 450cc may well work, but without an exam can only speculate based on my own personal experience with patients similar to you.I read all the time (here on RealSelf and elsewhere) that my plastic surgical colleagues are recommending high profile implants "for more upper pole fullness." High profile implants have more projection for a given implant volume, but also have the narrowest base diameter for that volume. Since the "proper" inframammary crease position is a "fixed" one (anything else is too high or bottoming out), the narrowest implant will have LESS upper pole fullness. Wider (moderate plus, or even wider moderate profile) implants will have the larger diameter that gives more implant volume and fullness below the collarbones. Sure, the HP implants give more upper pole fullness right after surgery before they have dropped, but aren't these surgeons seeing their patients more than once or twice post-op? If they do, they see that as gravity and scar maturation cause inevitable implant position dropping over 6-12 months, that upper pole fullness is lost when the narrower implants drop into final position.To summarize, HP implants give projection, but have the narrowest base and do NOT give upper pole fullness when dropped into final position. Moderate plus or moderate profile implants are wider and will, by mathematical definition, have more fullness when their lower edge is at the same exact crease position, simply by merit of their greater diameter. Forget volume and shape for a moment. If you put a 12cm diameter ball on a table and a 14cm diameter ball on the same table, which ball "sticks up" more in the air? The HP 12cm one? NO!!!But enough preaching from my soapbox.I believe much of what you are asking for is perfectly compatible and reasonable. You want as big as your anatomy allows. I don't think your anatomy would allow "too big," at least by your photo and goal description. You want upper pole fullness, not too narrow, a bit of "off the side" (commonly called side-boob), but teardrop-shaped breasts that don't over project ("torpedoes"). This would be best achieved by implants of the chosen size with the widest profile your pocket dimensions would allow, with submuscular placement and appropriate release of the inferomedial muscle fibers. I would caution you that you may not get to DD, and maybe not even a full D, but that your goals are compatible with "as large as your anatomy allows, and with the lowest profile implants in the volume chosen to center beneath the nipple areola complexes.Get additional consultations if you need them. I agree that HP implants look fake in a thin patient. Best wishes! Dr. Tholen

At 5’6 and 120 lbs. you are thin and in your photograph you
have a narrow abdomen. Implants as large
as 450 will not fit retro-pectoral, will extrude inferiorly and laterally
requiring revision. At size 32 each 100
cc’s of implant corresponds to 1 cup size change. 300 cc implants would take you up 3 cup sizes
to a D and 400 cc implants would take you up 4 cup sizes to a DD. I always recommend small round textured
silicone gel implants placed retro-pectoral since they look and feel more
natural, are more stable, less likely to ripple or have complications needing
revision. Implant profile is irrelevant
in the retro-pectoral since the muscle compresses it. I recommend smaller implants to avoid the
torpedo look you do not desire.Best Wishes,Gary Horndeski, M.D.

on your slim frame I would also recommend a high profile implant if you like the 450cc range.  This will help to keep the implant out of your armpit and still give you a pretty breast shape.  Sounds like you are on the right track

Dear HappyMomma79,If you want a natural look then 450cc high profile implants may not be right for you.  You might want to get a second opinion from a board certified plastic surgeon in your area.  Good luck. 

Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements. In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process. In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size. I wish you a safe recovery and fantastic result.Dr. Gill