What size implant would you recommend? I want a decent cleavage and natural shape

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Unfortunately, the statistics you provided are not sufficient to make any specific recommendations and an examination in person by a board certified plastic surgeon would be necessary to provide you with the answers you are seeking. Your description of your breasts raises the question of whether or not you would benefit from a breast lift in combination with breast implants, or if appropriately sized implants would accomplish your aesthetic goals.

Volume (300 versus 400), is far less significant than implant width and projection. Saline versus silicone is also important, as is "round" versus "anatomical" shaped.

Because all of these options to consider can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion to be sure and feel confident. Make sure that your surgeon sees photographs of your "favorites" or ideal. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Dear Uk35,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Implant selection is a process that is best done in person. During a consultation with your board certified plastic surgeon you will discuss your goals for surgery and measurements will be taken of your breasts. You will decide on volume, profile, type, and shape. In addition it will be determined if a lift is recommended. I've included a video that I hope you find helpful.

Great question! You will likely need a 450cc implant to go from A-D cup. Unfortunately, this will not likely look very natural. If your surgeon does not have some sort of sizing system made by Sientra or Mentor, I suggest getting another consultation. Make sure you are seeing board certified plastic surgeons with a lot of experience as it is tricky to achieve your specific goals.

the best way to determine what size you actually like is to go in for a consultation, be examined and measured, and try on the range of sizes that best fits your frame and tissue. Then, you can actually see what you like.

Implants are chosen on the base width af your breast and then on the profile that will add to what you have, to give the desired outcome. I would suggest that you would need a moderate or full projection implant, to give you the result you require.
Implant choice is made at consultation, having had the chance to understand your wishes and been able to examine you properly.
I would recommend making an appointment with a member of the British Association of Aesthetic Plastic Surgeons, to be counselled properly.