I’m 5’4” 112lbs, 32A. I am choosing between 265 and 295 HP under muscle implants, want to look natural. What should I do?

I agree that you will look best with either a high or an ultra high implant with your petite frame. You really don't want the implant to be wider than your natural breast. The 2 implant sizes that you have chosen are rather conservative, so either one will look very nice. When I have a patient trying to decide between 2 adjacent sizes, I suggest going with the larger size. Good luck!

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.
Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. I also take into account their overall height and weight, the size and shape of the underlying chest and ribcage, the tightness and elasticity of the skin, and the amount of natural breast tissue. Prior to the procedure, we discuss and make decisions regarding location of the incision, whether to place the implant under or over the chest muscle, and what type of implant to use (I offer multiple types of silicone gel breast implants, as well as saline implants).
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

Thank you for your question. The most important factor when sizing implants, is working closely with your surgeon, in person, to find the implant size that gives you the look that you desire. There is a small difference between the two implant sizes. High profile implants tend to give a more "augmented"look. If both implants are high profile, then it's unlikely that you will notice a significant difference between the two implants. I would consider returning to your surgeon's office to discuss further.

When in doubt… Go the next size up!  That is almost all women’s advise when choosing implants. There is not a huge difference between the two sizes you mentioned so when in doubt go a little but up rather than a little bit smaller!  Having said that, I am not a huge fan of high profile implants in primary augmentation. I find them very narrow and more of a tendency to a wide space between the breasts,  especially if you go to 265 cc. I only use them if the base width diameter of the breast is plus or minus 11 cm !  

Dear Chgn6476,
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