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

It does sound like this may be a reasonable
choice of implant for you however, as you can understand the ideal implants do
vary considerably with your physique, height, shoulder width and chest size - also the amount of existing breast tissue you have.It is very difficult from photographs to
give you an accurate idea of which would be the ideal implant for you as we do
like to do this in person with measurements.For this reason, your plastic surgeon will be best placed to discuss the best
option for you. As always, for your own peace of mind, I would recommend you get a second opinion by attending consultations with 2 or 3 other surgeons to be sure you are making the right choice for you. I hope this helps.

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.