Is 450cc saline unders too big for me? I'm 34A/32B, 5'6", 140 lbs. I want to be a full D/DD, proportioned to my body. (Photo)

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. 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 D/DD and a 38 D/DD are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer.

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 you discuss your concerns directly with your plastic surgeon  who should 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. 
Robert Singer, MD FACS

La Jolla, California

Hello! Thank you for your question. In general, implant size does not
correlate with bra cup size. The cup size itself will vary from
manufacturer to manufacturer as well as who is doing the actual
measurements. Thus, cup size is never a reliable indicator for your
breast size. I typically encourage my patients not to communicate her
desires in cup size but more on the actual look and appearance. Your
options would certainly be breast augmentation with implants or fat
grafting. Good communication between you and your surgeon of
your expectations is warranted - choosing your surgeon wisely is the
first step. Discussion of your wishes and having an honest and open
dialog of your procedure is mandatory (e.g, implant type, incision,
placement, lift, etc). I have found that photographs brought by the
patient is helpful to get a visualization of the appearance you wish for
in terms of size, shape, fullness, etc. In addition, your surgeon's
pre and postoperative photographs should demonstrate a realistic goal
for you. Once this has been accomplished, allow your surgeon to utilize
his/her best medical judgment during the procedure to finesse the best
possible result for you after preoperative biodimensional planning and
fitting the right implant for your breast width. Hope me that this helps! Best wishes for a wonderful result!