Asymmetry and breast implants.
Asymmetry is more pronounced following breast augmentation unless different implants or pocket formation is used to correct the original asymmetry. Slight differences in the inframammary fold are usually well tolerated (and quite normal). As for implant size, 450cc moderate plus implant is a large implant. This will definitely put you into the 'D' cup bra sizes. However, your goals of augmentation are not clear from your question. You need to decide what the goal of breast augmentation is for you?
Are you trying to achieve symmetry with a modest (ie natural) look?
Do you want to have a very full upper pole and don't mind if it's obvious you have an augmentation?
Are you looking for the largest implant you can safely have?
Define your goals of a breast augmentation first. Let your surgeon worry about asymmetry. If you are confused, why not seek a second or third opinion? Sometimes this helps patients identifiy what they are really looking for in regards to breast augmentation.
Nipple height asymmetry difficult to improve with only a breast augmentation
Breast asymmetry is very common and it is an issue that plastic surgeons must deal with on a daily basis. It is important that you recognize the asymmetries that exist prior to surgery as these tend to persist after surgery as well. There are certain anatomic features that we can correct and others that can not be improved with breast augmentation as a stand alone procedure. The asymmetry between the two creases can be corrected,. the differences in your breast volume and the differences in your breast width can all be improved by proper implant selection. The problem with nipple height asymmetry can not be controlled with only a breast implant. It is likely that with a properly performed breast augmentation you will get a nice result. Just do not focus on nipple height asymmetry as it is likely to remain unchanged.
It is as common as not for women to have some slight breast asymmetry. I to am concerned that 450cc implants might be a bit too large for you. The asymmetry could possibly be improved a bit by using two differnet sizes of silicone implants.
Assymetry and Breast implants
There is a lot to discuss with your situation;
1- Inframammary fold assymetry can be controlled during augmenation.
2-Nipple assymetry will be amplified with breast enlargement, so maybe you would like to reconsider adjusting your nipple position. In the photos, your nipple areola position seem significantly different from side to side.
3- Breast volume size with 375cc vs, 450 cc is a little less than a half of a cup size different. Perhaps a more important consideration is implant width and how it sits on your chest wall. Too wide and your breasts touch in the midline and sit under your armpits. Too narrow and there is a big space between your breasts.
4- The rice test can do a great job letting you know what volume is right for you.
It is possible to correct slight asymmetry with breast augmentation surgery. Clear communication with your plastic surgeon is important in achieving the desired goals of the patient. I like to communicate with patients with “goal” pictures. During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal. I think it is too much responsibility for the patient to choose the size of the implant. Ideally, the surgeon would make that determination once he/she is in the operating room with sizers in and examining the patient in the upright and supine position. There are many variables that come into play when choosing the correct implant size (how much breast tissue the patient currently has, the shape of the chest wall (concave vs. convex), etc.. Some places have you put bags of rice or implants in your bra – that is normally not very accurate.
On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a certified physician is always the best way to get the most accurate information.
Asymmetry After Breast Augmentation Will Persist Regardless Of Implant Size Chosen
The relevance of having asymmetry between the breasts before augmentation is that you will have the same or even more noticeable asymmetry afterwards. Implants merely take, in many cases, the asymmetry you have and makes it bigger, particularly differences in the position of the nipples. With a breast base width of 17 and 18 cms (I'm not sure that these have been measured correctly given your body size), I would go with the bigger of the implant choices. You have a lot of loose breast skin which needs to be filled and, depending upon your goals, you may end up less in size than you think even at 450cc.
you will have asymmetry afterwards. you dont say how large you want to be afterwards. 450 may be too much in someone your height goodluck
I agree that you have breast asymmetry. The right breast is fuller and wider and the nipple positions appear different. You have good volume of breast tissue in each breast thus adding an implant in the 300+ to 400s would make you extremely large.
P.S. awesome that you go to CrossFit!! Tough workouts !!
It is, of course, completely normal to have "slight asymmetry;" if anything, it's abnormal NOT to have that.
That applies to every part of the body for which there are two - including eyes, sides of the face, etc. You will most likely be slightly asymmetric after the surgery, too, and that - again - is entirely to be expected. For someone like you I would simply say that you'll be larger than you are now, and with a nice enhancement versus your current appearance.
It's understandable that you don't want to do anything about the discrepancy in nipple height (though that's hard to see on the photo you provided). As with the rest of the breast, I only suggest an "adjustment" when there is a fairly pronounced degree of asymmetry.
Of concern, though, for you is that implants have a certain amount of weight (450 grams is a pound) and you already have a bit of ptosis (sagging) - sorry! and nothing personal - so you expect that to be slightly more pronounced if you add what is essentially a one pound weight to each side. Not that you shouldn't do it - I think you'll look great - but that's just something else to be aware of.
And finally, on the size, that range seems like it will fit on you (only your own PS can make the determination in fact) and should be assessed at the time of surgery. I would urge you not to be "set" on an exact size. There is very little difference from one breast implant size to another. 25 cc is less than one ounce - the average size shot glass in the United States is 45 cc, or about an ounce and a half.
So I think you're on the right track. You can go over the sizes again with your PS, but it seems like a good plan, and I would not worry about the asymmetry, at least based on this photo.
I hope that this helps, and good luck,