Will 450cc high profile saline implants be too big for me? I'm 5'4", 124lbs, and I want to go from B to C/D. (Photo)

Sizing is perhaps the hardest decision
for a patient to make, as well as the surgeon. Cup size estimates can be
misleading, but I generally advise patients that they will experience an
increase of approximately one cup size per 200 cc. You can try on implants in
the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the final volume to account
for flattening of the implant in the partial submuscular pocket. Once you
decide on a size you like, then add on about 25-50 cc, because in real life the
implant will be flattened slightly by your tissues.Multiple measurements need to be taken to fit an
implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since silicone
implants wrinkle less than saline implants, they might be your best bet.You can also approximate this at home by
measuring out an equivalent amount of rice placed into a cutoff foot of old
panty-hose, and put this in your bra.Wear this around the house for a while, and see what you think.Implant size must square with assessments of
tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of
much discussion. Therefore, I use a wide variety of
methods, but the implant size is always established preoperatively.Also, patients are advised to bring reference
photos demonstrating their ideal size and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in
determining where the implants will be placed, since they can be shifted inside
(to provide more cleavage), to the outside, up or superiorly, and down or
inferiorly during surgery. In determining the final size selection, I always
place the highest priority on the preoperative measurements and potential
tissue cover. Then, the patient’s verbal requests are factored into the
analysis.Good luck, “Dr. Joe”

Unfortunately,
you have not told us your bra size just your cup size.If you are 32 or 34 each 100 cc’s of implant
corresponds to 1 cup size change.If you
are 36 or 38 each 200 cc’s of implant corresponds to 1 cup size change.From this, you can compute the volume
required to achieve your desired goal.I
always recommend small round textured silicone gel implants placed retro-pectoral
since they look and feel more natural, are more stable, less likely to ripple
or have complications needing revision.Implant profile is irrelevant in the retro-pectoral position since the
muscle compresses it.From your
photographs, your breasts are widely separated and pointing outward.You would benefit from a simultaneous lift
procedure.I recommend a new technique
called Breast Augmentation with Mini Ultimate Breast Lift™.Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage.Through the same incision, implants can be
placed.Aligning the areola, breast
tissue and implant over the bony prominence of the chest wall maximizes
anterior projection with a minimal size implant.You will get a better long term result by
using a smaller implant and simultaneous lift rather than using a large implant
such as 450 cc.450 cc implants weigh
about 1 lb each, will extrude inferiorly and laterally requiring revision.22% of women who undergo breast augmentation
alone require revision within 2 years because they are dissatisfied with the
result.Frequent causes for
dissatisfaction are over implantation and not performing a simultaneous lift
when needed.Best Wishes,Gary Horndeski, M.D.

If you go with the 450 cc implants you will more likely be a D cup rather than a C cup.  I don't feel it would be too large, but I certainly would go no larger.