How many cc’s would look best on my body? Currently have 397cc moderate plus saline implants (photo)

Your breasts are already wider than your chest wall and going larger would lead to complications. You would consider elevating your nipple-areola complex slightly higher and more medially. This can be done with a circumareola approach.

Best Wishes,

Gary Horndeski, M.D.

Dear Cheerful616835,
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

Ultimately you will be the person deciding on the size of your implants (within reason). Your surgeon’s input will be to provide support and information regarding the pros and cons of your decision but also advise on a size range that your body can accomodate. This range can be very broad. On top of the information you provided there are more landmarks and measurements to be considered. This will be part of your consultation with your surgeon

Based on the posted 1 photo, I would exchange to High Profile saline from 450-500 cc ranges. Fee $4,000+/- Best to virtual consult with...

Don't go bigger. You already have rippling from thinning your own tissue. Bigger will thin you even more and cause you to sag over time. Smaller implants would fit your frame better.