5'7", 145lbs. 400cc moderate or 450cc high profile? (Photo)

Thanks for your question.  I think you are on the right track seeking several in-person consultations with plastic surgeons before making a final decision.  They both gave similar recommendations but if you are still trying to narrow down the implant choice, I would recommend booking follow-up appointments.  This would be far more valuable than any advice that could be provided based on photos alone.

Know that breast augmentation and lift procedure together are technically challenging because the two procedure "fight" each other.  They both cause increase tension on the skin and the repairs.   Getting all 4 procedures (two on each breast) to match is a challenge.  If you want to get to the D cup range, this is even a more important consideration with the larger size.  The following recommendation is my opinion and not necessarily "the right answer".I would recommend 450 cc moderate profile plus saline implants placed in the sub muscular plane in the first procedure.  The saline implant are adjustable during the procedure to correct any asymmetry in size and get you to the D cup range.  After at least 3 month of healing, a circumareolar breast lift would be done.  This hides the repairs around the areolar boarder without the downward scar.  The saline implant size could also be adjusted using the same implants at that time.

Thank you for the question and pictures. Based on your photographs, I think that you are an excellent candidate for breast augmentation/lifting surgery. Online consultants will not be able to provide you with very specific advice regarding breast implant size and/or ultimate breast size achieved.

Ultimately, careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.

Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications.

Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural” or "D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.

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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.

I hope this, and the attached link, helps. Best wishes.