Please realize that you have already done the hard work of selecting a surgeon, having a consultation, and receiving recommendations from a specialist (always see only ABPS-certified plastic surgeons, even better if they are also ASAPS members) who has had the advantage of seeing you in person.To answer specifically between the two choices given, I can give you some generalizations.First of all, 20cc difference between the two implant choices listed is LESS than 2 tablespoons volume, and probably 1mm difference in dimension, so these should be considered near-identical implants. So close that if you had one in one side, and the other in your other breast, you would almost certainly NOT be able to tell the difference.So here is the second generalization--the real question here is not between the 255cc and 275cc implants, it is between either of these and visibly larger or smaller implants, which would require at least 50-60cc. So if you are pretty confident that these give you the look you want, then either will give you the look you want. If you tried these on in a bra in your surgeon's office, then your surgeon should add about 10% to your best choice to accommodate for submuscular compression. This would automatically tend to favor the 275cc implant, therefore, unless you really liked the look of the 275cc implants, in which case I wold suggest aroung 300cc.I know you stressed "super natural" and "absolute biggest . . . a baby D," but neither of these implants in a petite woman such as you (but no photos or examination to determine what present breast volume you have), should add much more than a full bra cup size to whatever natural breast volume you "bring to the party." So if you have an A cup breast size now, you will be a big B or small C. If you have a natural B cup in present size, then adding either of these implants will take you to a C cup or maybe small D (especially if you buy your bras at Victoria's Secret, for example, where "vanity sizing" is in full use!), so your own breast size PLUS implants is what determines final size, and is why examination of photos at least are essential to providing some valuable input here.In general, most women wish they had chosen just slightly larger implants once they get past 6-12 months and the "newness" or concern of encounters where someone "may know" or comment. Remember, this is about how YOU feel and look, and not what friends, frenemies, or significant others might say or comment on.Another trick--I always ask my patients to do a thought experiment with me in the pre-op area. I tell them we have the "perfect" size implants to give them the results of their dreams, and that I brought along one size (not bra size but implant size, which is 20-30cc, or two tablespoons) BIGGER, and one size SMALLER than perfect. Then, in this hypothetical scenario, of course, I tell them the "perfect" implants suddenly are no longer available--deserted island surgery and the shark ate them, or similar flights of fancy--and we now have to choose one of the two alternatives. She must tell me what to use, either the 2 tablespoons (invisibly) bigger than perfect, or the 2 tablespoons (invisibly) smaller than perfect. Sort of the "half-full or half-empty" question. The answer helps me decide, just as it should you. Then, in the operating room, individual anatomic considerations will also provide input that helps inform the final decision, as in "very tight and firm skin and muscle coverage" might lead me to choose the 255cc, whereas loose skin and thin muscle coverage may make the 275cc implants "fit" better.To really answer, I'd want to see your pre-op photos or do an exam, as you are average in height, but quite petite and slim, so what your own breasts look like, and what your goal photographs show as your wishes, really are needed here to provide the answer you want. All things being equal, I'd go for the 275cc implants just based on the history of most patients' responses down the road. Not to mention the fact that childbearing and breast feeding will likely be in your future and these almost always deflate breasts and stretch skin, not the reverse. Thus, the larger of the two choices given would be the obvious and most common recommendation. For more information on the entire breast augmentation process, you may want to read my Comprehensive Guide to Breast Augmentation by clicking on the web reference link below. Best wishes! Dr. Tholen
