45, 5'3, 148lbs, 275cc, silicone, right implants for me - subglandular? (Photos)

Hello,
Given that you have a decent amount of your own breast tissue, I would think that once the implants have fully settled you will not notice much of a change with 275cc implants. One of the main reasons patients are dissatisfied after breast augmentation is that they wish they had gone bigger.
Having an "unnatural" look is more dependent on how much implant volume to breast volume you have, not necessarily how large the implants are. The picture you posted noting what you do not want to look like shows a patient who likely had very little breast tissue to begin with and most of what you are seeing is implant.
I do think that a sub-glandular augmentation is a good option for you to help with your breast tissue sagging, this often does help patients avoid needing a breast lift right away. This will likely help more with adding upper pole fullness compared to sub-muscular as the top of the implant wont be constantly crushed by the pectoral muscles.
Hope this helps!
-Dr. Halka

Dear melissarn,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Based on your photos, I think the 275 cc implant will fit you very well. I assume since you don't like the rounded look, you are getting a moderate profile implant. This is a less projecting implant that will give you upper breast volume and a natural slope to the breast. Good luck!