450 cc or 500 cc silicone implants? (Photo)

Thank you for the question.  
Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.  Also keep in mind that there is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. in my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. 
 
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "up a cup size” or "C or D cup" or "huge" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 
3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this helps. Best wishes. 

Thank you for your question.  In my practice, to help my patients choosing the correct size, I ask them to come in and try our special sizers for a very accurate "final look".  Patients bring a sport's bra of the size they want to go up to.  In your situation, I would try an added 150cc versus added 200cc and you could decide while looking in a mirror.  I like to be personally present when discussing size in breast augmentation.I always recommend at least 100cc difference when changing size.  FYI, 150cc is 10 tablespons and 200cc is 13 tablespoons... so the difference between your 2 wishes is only 3 tablespoons.Hope this helps!Kind regards,Dr. Marc DuPere,