Should I get bigger implants? (photos)

Good morning!You do have a large gap and some bottoming out. Here's what I would do- open up your pockets more medially for better cleavage, use the Internal Bra, my strong permanent internal suturing technique, to correct your bottoming out which provides better upper pole fullness, and upsize to XHP 650-800cc!

Thank you for the question.
 There are MANY variables  involved when it comes to the aesthetic outcome achieved with breast augmentation surgery. For example, when patient's wish to achieve significant upper pole volume, factors such as positioning of breast implant "pocket"  along with selection of appropriate breast implant type/size/profile are all important.  
I prefer to have a wide selection of implants ( all profiles) available in the operating room. 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 breast 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.
 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 “volume on top”  or "D or DD 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.

Thank you for your question! Every patient heals differently. Push up bras are not typically recommended due to the risk of misshaping the pocket around the implant. Consult with your board certified plastic surgeon to see if your implants are bottoming out and if you are in need of bigger implants or a pocket revision. Seek a second opinion if needed to ensure you are comfortable and confident prior to proceeding with more surgery. Good luck!