Implant revision - Would 350cc reduce the risk of bottoming out?

i have had my implant rupture so I will be having a replacement. I previously downsized to 450 high profile silicone mentor implants 5 years ago with a lift. I bottomed out within two years . I have over over the muscle because I struggled with under the muscle discomfort. Since I bottomed out quickly before, I will now be adding mesh for support. But my concern is about what size. I was thinking that I might want to downsize to aim for a longer hold, perhaps 350 ccs. The Dr told me I would have to go to moderate plus size for that volume because the high profile would be too narrow for 350 ccs. But as far as size, he would not tell me if he thought that going smaller was a better choice for tissue health and longevity. I said well I have very little of my own breast tissue. I want to aim for not bottoming out so soon. Would the 350 be a better option for that? I could not get him to give me any indication because I'm guessing that it was to avoid liability etc. But I would appreciate some sort of direction. He said choose the look I want and to deal with the aftermath of whatever happens. But that doesn't sound like a solid plan to me. I really like the look I have now but i don't like the bottomed out look I might have soon again if I don't go smaller. I know nothing is guaranteed, but it seems like there would be less stress on my skin etc by going down. Just looking for a bit of advice