Downsizing implants. Should I go 220 LP? Is 245 too wide when going down in projection? (Photo)

You might prefer the smaller size and your surgeon could tighten your lateral pockets so they don't move as much.

Generally, speaking, low profile, implants look more natural. The indication for high profile implants is for patients who have limited breast diameter, and want to increase volume while still maintaining their natural breast diameter without distorting, the natural outline or contour of their breast.
The best indication for high profile implants is patients who want big breast, but have small diameter breast limiting volume other than in the projection.
The description of your proposed procedure sounds entirely appropriate.
Silicone implants may have some benefit of sailing in regards to look and feel, but there are many variables to take the consideration.
Discuss your options with your provider. Based on what you describe, your decision sounds appropriate.
Best,
Matt Hagstrom, MD