Why does my surgeon say he can only go up to 350cc for my breast lift. Is this size going to be small? I'm 5'6, 150lbs size 34E

At size 34, each 100 cc of implant corresponds to 1 cup size change.  350 cc implants would take you up to size H or I.  However, implants alone will not be enough.  The technique I recommend is a lift using The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.   Implants are not lifetime devices.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Hello.
Great question. Thank you for your images. The fact that you are getting a breast lift may limit the size of implants you may get. Follow your surgeon's recommendations. Please visit a board certified plastic surgeon for a detailed surgical plan to achieve your desired results. 

You need a formal evaluation by a licensed plastic surgeon and expert in breast lifts, revisions and augmentations to determine what is best for you and your goals.Breast lift surgery can improve a woman's breast shape by repositioning the breast mound at a higher position on the chest and then centering the nipple and areola on the breast itself. If there is enough breast tissue, I can perform a highly aesthetic mastopexy without the addition of further volume by internally rearranging the breast tissue and removing excess skin. If more volume is needed, especially in the upper portion of the breasts, we will discuss the possibility of fat grafting or silicone gel implant placement. The type of incision required for this surgery (circumareolar, “lollipop” or “anchor”) and the lifespan of the lift depends on each patient’s condition, breast tissue, genetics, weight and hormonal fluctuations, and desired results.
Augmentation with mastopexy is a challenging surgery that requires significant experience to create a shape that is youthful, natural, and proportionate to the body, while managing the native tissue as well as fat grafts or implants. When performed properly, it can result in a dramatic improvement to a woman’s breast appearance.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Lifts. - Dr. Cohen

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 to obtaining a natural result is to stay within the parameters defined by your BWD. With regards to your specific question, there is a balance that must be struck when combining procedures. A tightening procedure will be in direct conflict with an expansile procedure. Thus, one cannot push too far in either direction.
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
RealSelf Verified Member
Real Top 100
RealSelf Hall of Fame 

Breast lift when done with an implant in a single stage can be a complex procedure. It needs to be done safely without undue tension to avoid compromising circulation to the nipple and skin. On account of this the size of the implant is limited by the size of the skin envelope that can safely accommodate the implant. 

Please consult a board certified plastic surgeon for optimal outcome.

Great question!  Implant selection can be a difficult to discuss in a forum like this.  Due to the fact that you're having a full breast list you cannot go as big with an implant as someone who is not having a breast lift. However this is also determined by the dimensions of your breasts. Therefore it's important to see a consultation with a few board-certified plastic surgeons and go with the one you feel most comfortable with.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Dear natcali88,
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

When you get a lift the skin gets tightened leaving less space for the implant and making the skin closure tighter.  That is why your surgeon doesn’t want to go bigger.  On one hand I agree with him.  But I I think you could go larger than 350, up to 450 without a problem.

With a lift, large implants are not advised because the excess wait will just cause sagging. Your surgeon has measured and examined you and knows what range of sizes best fits your frame and tissue. Please do not go too large. Large implants stretch and thin your own tissue so it does not support well, and are heavy to cause more sagging.

A breast lift with implants is one of the most challenging procedures we as plastic surgeons perform.The breast lift is trying to tighten and lift, and the implant is trying to make things bigger; so in a way these two procedures are working against each other. When I have a patient wanting large implants, I usually recommend doing the breast lift first, waiting 3-6 months post op and then placing whatever size implant they wish in. It is just a safer way to have both procedures done.