High profile silicone 450 or 485 ccs for someone who Lost weight but still has about a B cup? Wanting fullness and pick me up.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It is hard to help accurately assess without individual breast measurements and pictures.  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.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

implant sizeThe best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look.This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus. I prefer the underarm approach so there is no scar on your breast. The new silicone is the only way to go as far a rippling as the new silicone ripples much less than saline, especially in the larger implants. I personally prefer the smooth round implants under the muscle placed through the under arm to give you the most natural look and feel. This also leaves you no scar on your breast.  Dr Scott Ennis - Plastic Surgeon – Destin and Miami , Fl

Thank you for your questions, but unfortunately trying to decide between two large implants that vary by approximately an ounce and discussing bra sizes, which are notoriously inconsistent depending on manufacturers, without photos to assess is absolutely impossible.  Don't fret about this rather insignificant difference.  More importantly, talk to your surgeon, utilize sizers to see what you will look like and be specific. No one on line will be able to give specific advice, especially without photos and statistics, like height and weight.  

My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) 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 "D or DD cup” or "more fulness" 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 (and the attached link/video, dedicated to breast augmentation surgery sizing concerns) helps. Best wishes for an outcome that you will be very pleased with.