Can my body type hold up to 450cc? I am 5'7 and weight 123lbs.

Dear katdmendes,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You
have not provided any photographs, but if you have lost 75 lbs it is most
likely your skin has stretched and you will need a lift.  At size 34 A, each 100 cc’s of implant
corresponds to 1 cup size change.  I
recommend a breast lift using The Bellesoma Method.  This technique will reshape your breast tissue
creating upper pole fullness without implants, elevate them higher on the chest
wall and more medial to increase your cleavage. 
Vertical scars are avoided, nipple sensation and the ability to breast
feed are maintained.  At the same time or
later, fat transfers can be performed if additional volume is desired.  450 cc implants weight approximately 1 lb
each and will displace inferior and lateral over time requiring a
revision.Best Wishes,Gary Horndeski, M.D. 

If you are 34 around (  if correctly measured), a cup size is about 100cc for you. However, many other factors need to be evaluated not just number of cc to have a good result: you skin tone, thickness, shape of your breasts, chest width, asymmetry, etc. Best is to have a physical exam by a board certified plastic surgeon in person.

 I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I do this with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Thanks for your inquiry, without measurements and an exam it is hard to advise.  It is not uncommon for a 450 cc implant to be used, so I am unable to comment on the risk of bottoming out that was proposed to you.  Please get a few in person consultations to discuss.

Hello and thank you for your question.  Congratulations on your weight loss.   The
best advice you can receive is from an in-person consultation.   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.  FACS
Harvard-trained plastic surgeon

There's no way of determining the appropriate size of the implant without an exam. Implant size and profile are the issues. Your PS will advise you what is appropriate.

If you can, you will easily handle that size in you as if you do not upsize what sizer you like by 10%, your implant chosen will produce an outcome smaller than what you saw in the mirror.  Implant profiles would have to fit within your anatomy (chest width and breast width) or problems will happen.  So let your surgeon show you how wide your implants will be on your chest and then you pick what you are most comfortable with.

 implant size
The best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look. This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus.  A consultation with a board certified plastic surgeon who takes careful measurements and talks to you about your cup size goals will be able to assist you in your decision. Good luck!

Dr Ennis Destin and Miami Fl

Thank you for the good question.  

You are correct: every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery.    In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant (than what is safely "allowed" by the patient's anatomy) can be problematic;  potential problems include breast implant displacement/malposition issues ( such as bottoming out, lateral displacement, symmastia...)  and/or significant breast implant rippling/palpability.

Ultimately, careful selection of plastic surgeon and careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

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

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, after the use of temporary intraoperative sizers.
I hope this  helps. Best wishes for an outcome that you will be very pleased with.