How to achieve an E cup from B cup? Will 520-560 XHP/HP cc be too big? (Photo)

It's a good thing that you already understand the need for a lift. Going 'big' however, may be an issue, particularly, if you are planning to have it done in one stage.  The implant selection is dictated by several factors i.e. breast width, amount of breast tissue present and chest wall configuration etc. Adding a lift to that adds more complexity to the equation.Consult with a board certified Plastic Surgeon and discuss in detail the pros and cons of having both procedures done in same setting. Best. 

Thanks for your question.  From what you say and your photos, I would definitely recommend a breast lift first.  I suspect that with a lift you would be around a C-cup.  Proper sizing requires careful neasurements and planning and I would think it risky to make a decision based on volume and projection alone without those measurements.  However, as rule of thumb it takes around 100-150 cc per cup size increase so to go from a C-cup to and E cup you would need around 450cc.  The volumes you are considering are higher and could make you larger.  It would be risky to put large implants in your breasts and perform a proper breast lift at the same time in my opinion.  Also, you appear to have quite loose stretchy tissues which would expose you to the risk of recurrent sagging with larger implants.  Under the muscle would be fine as long as the implants would fit.  Generally with a slim, narrow chest wall, you will need to go for UHP implants to achieve the volume you are considering.best of Luck.  I hope this helps.Mark Hanikeri 

Thank you for the question and pictures. Despite good intentions, online consultants will not be able to provide you with meaningful specific advice. Careful measurements, dimensional planning, and careful communication will be key.
Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “E cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.
The use of computer imaging may also be very helpful during this communication process.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.
I hope this (and the attached link) help.

From your photos, you will definitely need a breast lift to achieve your goals.  With regard to the size and type of implant, check with your surgeon.  They will make some measurements of your breasts and chest and evaluate your tissues for elasticity.  Ask if you can try the implants on in a bra, as this will help you decide which implant will be best for you.  Best wishes, Dr. Lepore.