Will 380 ultra high profile look disproportionate & fake on my frame? Would 350 high profile be better? (Photos)

Hello,  your surgeon will be the best source of advice regarding your implant choice.  Sometimes patients find aids like in-bra sizers or virtual imaging to be helpful in making a final decision.

Based on your photographs, I think that you are starting a good place and should have a very nice outcome with breast augmentation surgery.Although you will receive many (and differing) opinions online, none of the opinions will be relevant to you specifically, when it comes to your specific anatomy and personal goals.  For example, I have many very happy patients who have utilized  ultra high breast implants to achieve their desired outcomes. These patients have ranged from very petite to larger patients.  In other words, nothing will replace in-person evaluation including a careful physical examination and careful communication of goals when it comes to providing you with specific/relevant advice. Given your concerns, I would suggest you spend additional time communicating your concerns/questions directly with your plastic surgeon, preferably prior to the day of surgery.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) 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. For example, 
I have found that the use of words such as “natural or fake look” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery for petite patients) helps. Best wishes for an outcome that you will be very pleased with. 

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.