I have struggled with my weight all of my adult life, bouncing between 175 and 140 lbs (I'm 5'8" tall). Gaining and losing that several times has taken a toll on my breasts, and I first considered getting a lift when I was 28 years old. I held back, because I thought I should wait until after I had kids. Now I'm 35, with a great career, no kids, and still single/dating. I've waited long enough to fix something that I'm very, very self-conscious about. Now is the time to act.
I decided to have a BL/BA in February 2015. During my research phase, I visited two Denver surgeons and two Washington D.C. surgeons, all of whom had strong online reviews and specialized in breast surgery. I chose Dr. Steven Vath of The Cosmetic Surgery Center in Denver based on his excellent reputation, his cost (mid-range for well-regarded surgeons: about $9,000), and pictures of his work. He seems to consistently produce results that have the slope, shape, and nipple placement I'm looking for.
Dr. Vath has an enthusiastic attitude; he speaks quickly, and answers questions thoroughly. During our initial consult he didn't use a book of photos, or ask me to pick out "what they like" (a couple of the other doctors did that), but he did draw and point out the characteristics that make an attractive breast, and a successful BL/BA. What he drew, and how he spoke, told me we were on the same page regarding what looks good.
Just to be sure, I scheduled a follow-up consult to re-try sizers and to bring in some photos. I didn't want to order a set of boobs out of a catalogue, but I did want to point to what I liked/didn't like. I put the photos on the desk and asked Dr. Vath to educate me about what achieved certain looks, and to find out if what I want is achievable. We looked at each picture, and I felt like this helped me communicate what I wanted. However, it also gave him a chance to explain how much a woman's body and original breast shape influence the BL/BA end result. He believes he can help me achieve the most attractive result for ME, which I totally appreciate. If a doc told me he could make my bust look exactly like Scarlett Johansson or Rosie Huntington-Whitely, I'd be suspicious.
Bottom-Line: if someone goes in seeking porn star boobs, or a chest exactly like movie star X, I don't think Dr. Vath is their man; but for a "natural plus" look (like God intended, but a lot better), I think he's the guy.
My stats: I'm 5'8", 150lbs, with a medium frame, and I carry weight in my thighs and butt (kind of an athletic pear-shape). I currently wear a 36B bra (Victoria's Secret sizing). I tried a range of sizers from 375cc to 450cc, and settled on 415 HP Sientra round implants. They look proportionate on my body, and balance my pear-bottom.
A word on High Profile (HP) versus Moderate Profile (MP). When I started this journey, I thought HP = porn star, and MP = natural looking. However, when I actually tried on the sizers I realized that the MP gave me a slight "side-boob." Some people might find it curvaceous/hourglass-y, but on me, it looked a little matronly/heavy. I liked the narrower diameter of the HP.
Also, back in my first days of research, I thought I wanted as natural a look as I could possibly get. Really, really natural! But in looking through pictures online over the past few months, I realized I like a little upper-pole fullness at the top of the breast. It seems younger, more modern, more sexy. Particularly if the bottom of the breast has the right, rounded shape to balance it... and that's a Dr. Vath specialty. So between the narrower diameter, and wanting more fullness on top, HP felt right.