405cc or 445cc? Natrelle, Mod Profile, Dual Plane scheduled for the 30th of May. I am 5"4', 160lbs and have a bw of 13 (Photo)

It sounds like you are making a very thoughtful analysis.  My suggestion is to first be happy with the volume.  Don't let your spouse or friend talk you up or down.  Then, consider which style of implant has a base width that complements and  respects your natural base width.  Your question whispers that 405 is big enough for you.  Speak with your surgeon regarding plans for the inframammary fold.  A good plan can usually be executed successfully.  

Thank you for the question and pictures. I think you are asking very thoughtful questions especially in regards to concerns regarding the lower pole constriction.   Hopefully, you have chosen your plastic surgeon carefully, based on significant demonstrable experience achieving the types of outcomes you would be pleased with.My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery if possible) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
 Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.