Tuberous breasts are a very common occurrence. Unfortunately, the issue of selecting the correct implant size in circumstances such as yours actually has far more to do with your skin laxity/elasticity than your personal preference. The biggest mistake that can be made is to "oversize" your implants. Personally, 450-500cc implants are larger than I've ever used in the primary surgery for tuberous breasts. My average is approximataely 350. As part of the surgical correction of tuberous breast deformity, it is typically necessary to downsize your areola. This involves removing the excess pigmented skin to make your post-operative areola an appropriate size (usually about 38-40mm in diameter). In doing this, if the implant selected is too large, it will dramatically compromise your post-operative result. As I explain to my patients prior to undergoing this operation, correction of tuberous breasts is not a typical "cosmetic" breast operation. The patient and the surgeon must be reasonably conservative when selecting implant size. Once the operation has been performed and you've safely healed, if your displeased with the size you can always return to have the implants upsized. Although this may sound undesirable, it's a far better option than having difficulty with healing following your initial operation. Start by visiting a Plastic Surgeon board certified by the American Board of Plastic Surgery . He or she can discuss expectations with you and outline a plan that you'll be happy with and with predicatable, safe results. Good Luck!!