380cc/420cc or 400cc/450cc? Moderate + or high profile? (Photo)

The
best way to determine the size for your personal perception of the perfect
breast is to try on sizers. This way you can see how they fit on you,
how they add to your current volume, and whether they fit your frame.
Although the surgeon can guide you, only you will be able to tell what is
the right size. Try on sizers.  I agree with going under.  There are many advantages to that approach.   HP implants, which are a more
modern shape than moderate profile implants, fit most women better. They
have a more appropriate base diameter for most women and can be made to look very natural or
very augmented, depending on where in the range the implants are filled to
achieve a particular volume. High profile implants are the first choice
in my opinion. I rarely find an indication to use moderate or moderate
plus implants. The subtlety in the final outcome is not achieved by which
profile implant is used, it is determined by the skill in the creation of the
pocket, the choice of volume, and where in the range the implant is filled. With respect to volumes, if you want to be a D/DD then 380 is going to be too small.  You might get closer with 450 cc.  Try sizers on again and see what you really want.

Thank you for the question and pictures. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Unfortunately, online consultants will not be able to provide you with specific enough advice (regarding specific breast implant size/profile) to be truly helpful. Given that your surgery is coming up soon, I would suggest that you spend more time with your plastic surgeon communicating your goals carefully.
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. In bra sizers can be useful communication tools also. I have found that the use of words such as “natural” or "full D or DD cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during the communication process.
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, and the attached link (dedicated to breast augmentation surgery concerns), helps. Best wishes for an outcome that you will be very pleased with.

Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements. In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process. In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size. I wish you a safe recovery and fantastic result.Dr. Gill