There are multiple measurements that are used to carefully choose a safe implant for you. I strongly encourage visiting a board certified plastic surgeon who performs breast augmentation surgery on a regular basis. He or she can guide you to the right implant and likely can have you try on that implant in the office so you can deterimine if that is the correct look/size for you. Best Wishes!!
5’3’’, 135lbs, 36A and Getting 450CC: Should I Go Bigger?
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Breast implant sizing
The more breast surgery I do the more I realize that there is no correlation between the size of implant and resulting cup size. This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saiine/silicone and low/moderate/high profile), bra manufacturer variance in cup sizes, the degree of filling of the cup with breast tissue, and the subjective differences in patients perceptions of cup size.
It will be very important to communicate your size goals with your surgeon. 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” or "fake looking" 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. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. 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. By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
Picking the correct breast implant
Picking the correct breast implant is a personal decision. You, as the patient, need to be satisfied with the size that you choose. However, it is incumbent on your plastic surgeon to choose a breast implant that matches well with your torso and breast measurements.
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Choosing breast implant sizes
For both the patient and her plastic surgeon, a lot goes into the decision of implant size: it is not as simple as picking a certain sized "cc" implant and expecting it to look good on your chest wall. From your height and weight, and the size implant you mention, I think it is likely too large; in other words your soft tissue would be unlikely to accomadate these size implants. It is important to have an honest discussion with your plastic surgeons (get several opinions and find someone your are comfortable with) regarding what you want and what he or she feels is realistic. We all like to please our patients and work with them to achieve their goals but we have an obligation to make sure, based on our experience, that it will both look good and not generate more problems in the near and/or distant future. Pictures that you show the plastic surgeon can be helpful as a talking point, and you can review his results. In the end, you need to be able to trust your plastic surgeon to implant the appropriate size, based on what he "sees" at the time of surgery. Based on the popularity of this surgery, the "take-home point" can be that most of the time most patients achieve what they are seeking. Take plenty of time to make your decisions.
How to pick breast implants.
1) This is the most common type of question on RealSelf.
2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.
3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.
4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.
5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.
6) The surgeon should have a large inventory of different size and shape implants available in the operating room.
7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.
8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating room inventory, and put in your breasts to complete the operation.
Should I go bigger than big?
Without photos this is hard to answer. At a height of 5'3" it is difficult to believe that you have wide shoulders and chest. I answered this before; it is not the cc's that count, but what is appropriate for you based on your measurements. You can go bigger than 450cc, even 800cc, but you will end up a "breast cripple" by destroying your tissues by overstretching them. If you choose this route, you might make some plastic surgeon happy (or miserable), since you will require multiple surgeries.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.