Of course, your present size, MINUS the skin and tissue removed to perform the lift, PLUS the implant size, will EQUAL your final size. With 32DD deflated breasts, you have a petite chest circumference, lots of loose skin, and (an unknown amount of) your own breast tissue. Let's say you have B cup volume in DD skin--so estimate 400g of your own tissue. NO MORE than 30-45g of skin need be removed for any breast undergoing lift plus enlargement, and to this you want to add 535cc (or 590cc from another of your questions), so you could potentially end up with around 900cc breasts trying to be contained in a reduced skin brassiere. This may not work. Surgeon's solution (doesn't want to junk to too-large implants--that costs $1700 or half, if only one implant is placed before s/he finds out the skin is too tight and won't close): just remove some tissue and now it will fit. And tell the patient that this provides "more upper pole fullness," or makes "your lift last longer!" I call BS on that! Why would you remove REAL breast tissue and replace it with implants, even if they are designed to resemble and "feel" really close to breast tissue, when you already have real tissue and wish for more volume? Leave what you have, remove the least amount of skin necessary (trust me, even with huge deflated breasts, it's NO MORE than 1-2 ounces of skin, and I proven that for over 30 years) to do the lift, and add implants to the desired size, or if that is larger than the skin capacity will safely accept, use the largest safe implants that "fit." Most, if not all, plastic surgeons are trained (if this surgery--lift plus implants--is being done as a single-stage operation) to do the skin removal first, create the implant pockets, place the desired or chosen implants, and THEN (try to) close the incisions. And if it doesn't "fit," what then??!! You must either try to "HONK it shut" after more dissection (bad if skin dies), use smaller implants (costs more, plus bad to have to explain that to a patient, especially if she remains too small), or remove tissue (but we now have "excuses, er, advantages" to removing tissue and adding large(r) implants.) And we now have professors actually training tissue removal (more than just the 1-2 ounces of skin to tighten the skin brassiere) and use of (larger) implants, justifying this with the reasons noted above. How about actually removing the ounce of skin to do the lift, actually CLOSING the lift incisions (leave 4cm open in the crease incision to later add the implant) FIRST, and now you have lifted, perky, still too-small breasts that you can now add implants to, through the incision still left open (same operation, just different order of steps)! This allows proper implant choice and prevents the too-large implant being "forced" into too-tight closures that fall apart or have inadequate skin circulation so the skin dies. You have probably seen plenty of those photos here on RealSelf! Closing the lift incisions, and THEN picking implants that fit, I would humbly submit, is a BETTER WAY (safer, more exact) to perform a single-stage lift plus implants! I can't be the only PS who has figured this out. Sorry, but 400g of tissue MINUS 250g of tissue PLUS 535g (cc) of implant weighs the EXACT same as 400g MINUS 30g (skin for lift) PLUS 315cc implants (685g per side). And this weight exerts the same amount of gravitational stretch on your new skin brassiere. So lifts "lasting longer" with larger implants after more tissue removal is not true! If the lifted skin allows bigger implants and you want an even larger look, then great, go for it! Why some surgeons' answers to your similar question have expressed a thinly-veiled skepticism at 535cc or even 590cc implants has nothing to do with width, but volume. Width (profile) is easy--once your surgeon decides what implants you want (and that fit), then choose a width (profile) in the desired size that is 1cm narrower than the actual in-surgery pocket diameter. (BWD is measured so differently by different surgeons it is not applicable, except by that specific surgeon-measurer. I may measure differently, but in the same manner for each of my own patients, so my numbers and choices work, for me). I know, choosing implants in the operating room can't be done if your surgeon has to order a few sets of implants for your surgery, so a decision HAS to be made pre-op. I prefer using ACTUAL measurements from the operating room, with the patient's sizing goals, and goal photographs of the desired result, and THEN decide what implants to use after the lift has already been (nearly completely) closed. (Our surgical facility stocks all sizes and profiles for two cohesivities of silicone implants, and saline implants, so we have the ability to choose final implant size in the OR.) If the result is not big enough, "forcing" too-large implants into not-enough (after tightening) skin is a recipe for disaster. Or you have to remove more tissue. You can always heal, soften, stretch, and settle for 6-12 months, and then come back for larger implants, if that is your goal. I hope this answers your question, and perhaps the other as well. For more information (more about augmentation than lifting), you may be interested in my Comprehensive Guide to Breast Augmentation found by clicking on the web reference button below. Best wishes! Dr. Tholen