My breasts can look quite bulky at times and sometimes just right. What size/shape would you recommend? (Photo)

Dear SunnySoCal,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Proper naked breast photos with anterior and both sides would aid in accurate assessments. That being said...
Your breasts look very nice now, but you are in very good shape with a narrow waist line. This makes the breast look even larger. 550cc implants are very large, even for your frame. Downsizing would require more than 50cc's, so consider at least 75-100cc reduction. I am still thinking of changing to a moderate + implant and suturing the lateral pockets so the implants stay more medial/midline, vs lateral towards the armpit.
Before photos also help in deciding on the new implants and any anatomical concerns.
Best wishes,
Dr. Taranow