| Size is the issue
Choosing a size is one of the most difficult decisions you will make. The profile of the implant does not matter as much as the volume does. The high profile is only appropriately used when someone wants to be larger than their chest diameter can tolerate. Going with the base diameter you describe the volume that matches your chest is in the mid 300's. Therefore, wanting to be noticeably larger and going with volume in the mid 400's, the best choice is a high profile implant to stay close to your base diameter. Otherwise the implant will be too wide and tall for you as you mentioned. Discuss your sizing with your surgeon in detail. You have to balance being happy with your size, with being happy with your shape, along with long term issues such as tissue stretch and sagging of your breasts, implant visibility, etc. Satisfying all those criteria usually means compromising on something. If you care about appearing as natural as possible while still getting the fullness you want, may want to consider just a bit smaller size such as in the high 300's. Obviously you and your surgeon who has examined you will give you the best advice. Make sure you discuss the pros and cons of your implant size. Cup size is inaccurate due to different manufacturers and designers. But I would suggest that with a volume in the mid 400's you will likely be a larger D and with a volume of mid to high 300's you will be a larger C and might even be a smaller D with some bras. Buy the bras that you would like to fit into and have your surgeon provide you with 440, 450 sizers and put them into the bra and see how they fit. Then put a form fitting shirt over the bra and look in the mirror to see if that is the look you are trying to achieve. I hope this helps. Let me know if you have any other questions. Good luck. You will do well.
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