I am having a breast lift and 445 cc silicone implants. I'm 5 ft 6 146 lbs. is that size of implant going to be large enough?

I appreciate your question.

The size of implant is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Thank you for your question and photographs.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing an ASPS board certified plastic surgeon, they are in the best position to ensure that the implants the two of your decide upon are the right ones to meet your expectations.  It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes!

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Adding photographs would also be helpful in giving you the most accurate advice.  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

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.
With regards to your specific question, "large enough" is a relative question. Without photos, wish pics or measurements it is difficult to offer any real advice. The best advice is to love a look not a particular cc value or cup size.As always, discuss your concerns with a board certified plastic surgeon (ABPS)

Dearkelysnewlook,Determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Your pictures would have been helpful. In general the size of the breast implants will depend on the size of your breast and your expectation. Please send pictures.

The best cosmetic result in any particular breast
augmentation patient depends on a variety of factors, including: Your
individual anatomy, realistic expectations, a thorough discussion with the
plastic surgeon about the options, and an understanding of the pros and cons of
any particular implant choice. Proper sizing is not just about the number of
cc’s. or the type of implant. The thickness of your tissue, breast dimensions
which include the width, height, and projection, as well as chest wall width
all need to be considered when choosing an implant. Trying on implant “sizers”
of various shapes and volumes while wearing a tight t-shirt, bra, or bathing
suit at a preoperative visit will help you and your surgeon choose the optimal
implant.

Keep in mind that following the advice from a surgeon on
this or any other website who proposes to tell you what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of each operative
procedure would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally
a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Dear kelysnewlook:
Determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient's desires and reasonable expectations. We have our patients bring 3 photographs of their desired breast size. We ask for nude breast photographs because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photographs and take detailed breast measurements during a physical examination. This includes a discussion of bony chest wall anatomy, any asymmetries and evaluation of the skin-soft tissue envelope. Next, we use a sizing algorithm to determine a range of implants that will work based on the examination  and the measurements.We use actual sizers in a sizing bra to simulate projection and weight. If needed we use computer imaging via Crisalix  to further define size.  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 its too small, we start the process over with a slightly larger implant. While there are no guarantees in life or in surgery we feel this helps with meeting realistic expectations. If you are unsure of your size notify your surgeon. Ask questions and always use a board certified plastic surgeon. Good luck and I hope this helps!