Should I get 200cc or 250cc implants? Or larger? (photo)

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.
The key is to respect your BWD. It is impossible to say for certain whether a 250 cc implant will deliver a B/C. Too small is a relative question. That being said the key is to respect your BWD. I would not struggle over a 50 cc differential (slightly more than a shot glass), as this is unlikely to make a dramatic difference in outcome. Both of your choices seem reasonable.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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While there is no way to predict with 100% accuracy how your breast will look post-op, I would hope that a thorough exam and measurements were done to choose the best implant for your breast. Being 5'8, you could maintain the 250 cc implant. I am sure your surgeon will take the time to make sure you are happy, helping you choose the appropriate implant for your aesthetic desire. All of us want to make sure our patients are happy and 100% comfortable with the procedure. If you have additional questions, contact your surgeon. I'm sure they won't mind talking with you.

Hello and thank you for the question.  An in-person consultation is needed to give you a useful advice and I would suggest that you discuss this with your plastic surgeon. In a typical consultation, you try a variety of in-bra sizers and in combination with several other measurements that your surgeon will do, the final implant volume is selected. In-bra sizing tends to under-estimate the final volume because of the extra-volume of the bra and the superior displacement of the breast tissue. So, I would usually go slightly larger. Use of 'goal pictures' is  also an effective way to communicate your goals with your plastic surgeon. My best advice is that you communicate your goals and aesthetic ideals with your surgeon as clearly as possible and trust your surgeon's skills and abilities to deliver what you are looking for.
Best wishes and good luck,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon