I had a lift and augmentation with 420cc saline implants. I didn't get the size increase I wanted. Any suggestions? (photo)

you look great and you certainly don't have small breasts.  There is always the option of going bigger but I wouldn't recommend it because of the problems with larger and heavier breasts implants - more bottoming out, more back pain etc

You results look great. I would suggest that it is too early to worry. I would also tell you that your surgeon is the person to go to first. Give them a chance to hear your concerns as your results look great. There is a limit as to how big of an implant that can be placed especially when doing a lift at the same time. In my opinion from your pictures I can not imagine going much bigger but I am sure it can be done.

It appears you are a DD cup from the photos but careful measurement will confirm this.  Are you looking for much bigger?  You have cleavage that is touching so going larger can only result in symmastia or an uniboob.  The only way you can go bigger is to use an ultra high profile silicone implant.  The other option is to try to overfill your current saline implant.  If you have 420 cc high profile saline implant and if it happens to be Mentor HP then you can fill those to 500 cc.  If its Allergan then only can fill up to 450 cc.  What you also need to understand when a lift is done the skin envelop becomes very tight and it is difficult to make the breast huge and still get the wound edges to come together.  I would say wait till the incisions have healed and then either add more volume or change to a larger implant at that time. 

Although I understand your concerns, it appears that your plastic surgeon has done a nice job with your operation. Generally speaking, patients undergoing breast augmentation/lifting surgery should understand that there may be limits as to the size of breasts implants that can be utilized SAFELY  during the combination breast augmentation/lifting operation.  You will find some of the issues at hand discussed in the attached link.Assuming you are working with a board-certified plastic surgeon, I would suggest that you continue to follow-up with him/her. If, in the longer term you remain dissatisfied, discuss your concerns/options in a calm/constructive fashion. Working together, it is likely that you will be able to undergo revisionary breast surgery to further increase breast size in a relatively painless/safe fashion. Best wishes.

I would take this discussion up with your surgeon in a non confrontational manner in the future.  All surgeons want their patients to be happy.Dr. Corbin