Lopsided & want to go bigger - 415cc moderate to high profile 550cc? (Photos)

The size you have now is good, but I would suggest adjusting the pocket so that your implant sits better. Going up to 550 will stretch and thin your own tissue more, be heavy on your neck and shoulders, be more likely to sag and/or bottom out from the weight, and be less soft since more implant will be felt and less of you. The 550 size is too large for your frame and tissue. You have little natural breast tissue.

This is not a problem that will be fixed by adding a larger implant. I would highly recommend against going larger as this will not help create symmetry; large implants only create more soft tissue stretch over time and can create significant malposition problems that are one of the hardest things to fix in breast aesthetics. This is a complex problem to address. I would recommend placing significantly smaller implants with capsular work to make the pockets more stable/symmetric. I would recommend seeing a board-certified or board-eligible plastic surgeon with actual training in plastic surgery and an aesthetic fellowship. I find it also very beneficial if the surgeon has 3D imaging that can help simulate your revisionary surgery prior to the actual case. Best of luck!

Dear Modest2368,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery