I need to decide between high profile implants and moderate plus 550 cc. Any suggestions?

My suggestion would be to return to your surgeon and sort this (important) matter out BEFORE your procedure.An online question without sufficient information about you, no physical examination, no photos, and only a cursory understanding of your preferences (" I don't want to look too big and fake . I want lift and fullness"), diminishes the value of any specific advice offered here.

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 implant shape. 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 sit at a preoperative
visit will help you and your surgeon choose the optimal implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 DD and a 38 DD are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer. There is also no
direct correlation between an implant size or shape and resultant cup
size.
Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly 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