15.5 BWD, 5'11", 170 pounds. Is there a huge difference between 640cc moderate profile and 770cc high profile?

At size 36, each 200 cc of implant corresponds to 1 cup size change. 640 cc and 770 cc implants are too big, they will not fit submuscularly and will descend inferior and laterally. Unfortunately, you have not provided photographs. Sometimes a patient will benefit from a simultaneous lift with either fat transfers or smaller implants.

Best Wishes,

Gary Horndeski, M.D.

Both implants are large and heavy, and I do not recommend the larger implant because of the weight on your tissue, neck and shoulders. If you are a B cup, you should be able to go to a D cup with a smaller implant like 400 to 450 cc's. I would suggest going back to your surgeon and trying on sizes again, especially something in the 400 range or even 500 range. Implants over 500 cc's do carry higher risks, especially with thinning and stretching your tissue and sagging.

Dear Blair1710,
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