Would you recommend 405cc or 445cc implants for me? I don't want to look top heavy. Thoughts or advice? (photos)

As long as both sizes are more narrow than your breast width, I would suggest the larger size. Forty cc's is less than 3 tablespoons, so not that much different. If you pick the smaller size, you will most likely wonder if the larger size would have looked better. Good luck!

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. I also take into account their overall height and weight, the size and shape of the underlying chest and ribcage, the tightness and elasticity of the skin, and the amount of natural breast tissue. Prior to the procedure, we discuss and make decisions regarding location of the incision, whether to place the implant under or over the chest muscle, and what type of implant to use (I offer multiple types of silicone gel breast implants, as well as saline implants).
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

hello thank you for your question and provided information as well. based in you question and the picture you showed you are a good candidate for breast augmentation with implant position submuscular in your case is recommended get a consultation on personal to evaluate how many cc do you gonna need to very well result.

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
That being said, 405-445 cc is a small range (40 cc differential is approximately the volume of a shot glass) and is likely make only a subtle difference. And most importantly...remember to love the look...not the cup.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame 

Dear beachgirl1982,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Try on a profile bra with 405cc and 445cc implant sizers under a tailored blouse, tight sweater, swimsuit, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected.  You may not be able to discern a difference in 40ccs.
I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.  Based upon his/her credentials, trust your board certified plastic surgeon to make the best decision in the OR when the implants are placed.  
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Thank you for your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional ASPS board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations.  It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes! 

First I would like to say thank you for your question. Typically patients find that their biggest complaint after surgery is they wish they had gone bigger. So my advice when patients have narrowed it down to a few sizes is to go more toward the larger of the two. One issue unique to your breast is you have a mild constricted lower pole of your breast. This is worse on the right then the left. The surgeon should opt for either the crease incision or the NAC ( nipple ) incision as the optimum way to improve this issue. The more you play with sizing devices the more likely you are to be happy with the final size. There are websites such as the rice test site that also help with this. You should end up with a very nice result just make sure your surgeon has noticed the constricted lower pole so he or she can obtain the best overall shape and result. Best of luck.

Hello and thank you for your question. You are a great candidate for a breast augmentation.  If you are concerned about appearing too top heavy, then you may want to consider a smaller implant. The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

To answer your question about size and how many cc’s you should get based on the size you want to achieve, first you need to take into account what's known as your base width diameter.
Imagine lying on your back and drawing a circle around your breast. If you were to draw a line across that circle, it will be a given length. Your plastic surgeon will measure this length, which is called ‘’base width diameter’’ or BWD for short. For women, the base width diameter can go from 9.5 cm to 16.5 cm, or 3.75 to 6.5 inches. As you can see, there is a very wide range. 
For example, a 405 cc implant on a woman with a BWD of 10 cm is very different than 405 cc for a woman with a BWD of 15 cm. On one it may be enough volume, and for the other it may be much less than the desired result. 
As far as the placement of the implants, placing them under your muscles - this is still the most popular technique for a variety of reasons, one of the biggest advantages is that it prevents rippling and it also hides the implant better. It is probably still recommended to replace the implants under the muscle, but a discussion of your goals during the consultation will help determine the final position.
I hope that answers your question on size. It’s great that you’re doing this research. I always say that the best patients are informed patients.
Thank you for reading and best of luck on your journey!