Wanting some input on breast size and projection for my body size/shape (Photo)

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing. Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan.
With regards to your specific question, it is difficult to offer guidance without measurements.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Dear TerrificTexan,
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

In general, breast implants will help you meet your goals. That size implant does sound reasonable, however your optimal result will come from tissue based planning once your surgeon takes your actual measurements. Although your nipple is not particularly low, there is a fair amount of lower pole skin left, therefore a lift procedure may be required to reshape the lower pole.

Hello,

Thank you for the question.

Based on your photos, you appear to be a great candidate for breast augmentation.

Implant size discussion and implant selection is one of the most important steps during your consultation with plastic surgeon. The decision-making process depends on patient’s desires, as well as breast and soft tissue dimensions. 400cc size implant high profile will likely give you a fuller small D cleavage, but bra sizes vary between different brands.

I would encourage you to seek a consultation with a Board-Certified Plastic Surgeon to further discuss your options, specific techniques, concerns and expectations.

I hope this helps.
Best regards, Dr. Karanetz

Dr. Irena Karanetz
Breast Fellowship-Trained
Board Certified Plastic Surgeon

Thanks for your inquiry and pictures. A set of breast measurements would be helpful. Given the averages of breast measurements with someone with your height and weight, 400 cc HP is definitely in the family of good choices. Please have an in person consultation with a board certified plastic surgeon to learn more about your options.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

The fact that you indicated you were 'thinking of 400 cc silicone high profile' tells me that you believe that a given implant will give you the same result that you saw in someone else. It won't. The best thing to do is go to a surgeon who sizes you in the office. Dispel any notion of an implant or bra cup size you may want. They are irrelevant; the only thing that matters is liking what you see in the mirror with the appropriate sized sizer in a bra under a shirt.

Your breasts are low on the chest wall and you have very little upper pole fullness. You would benefit from a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Breast sizing can be a stressful decision. You want to get that size just right and there are a lot of options.
I use a 4 step approach to determine the right size. First we discuss goals, sometimes look at wish pictures to help get a visual. Then we do an exam to determine your various anatomical consideration - breast volume, skin laxity, asymmetry, need for lifts etc. Then we try on sizers and see what volume you like to get is in the right ball park. Finally, we put that all together with a 3d simulation that you can look at later at home.
It sounds like you've narrowed down your general volume goals. Based on your photos you might be a candidate for a moderate or moderate plus profile. You have decent baseline volume. The left breast looks larger so you could use a 445 on the right and 405 on the left. A lift could be benefit but you might be able to get away without one.
High profile might work as well but an exam with measurement would help determine what you fit your frame the best. I tend to prefer Natrelle implants and I would think their moderate you give you a great result.
Seek out a few consultations with board certified plastic surgeons to ensure you're getting the best result possible!

My advice is to let your surgeon advise you as to the profile and size that is best for you. I do it biodimensionally, based on the diameter of the breast. Of course you are a partner in the decision, but let your surgeon use his or her experience. That is what you are paying for.