What are some of the long-term effects of XL implants, if any?

Larger implants can lead to increased skin stretch, but that is not the only factor at play here. Genetics, native skin stretch, shape and weight of existing breasts and fluctuations in weight all contribute. Just because someone has larger implants, doesn't automatically mean they will have sagging breasts in the future.  I have found that women with a taller frame and broader shoulders can handle a larger implant for the right look. A certain sized implant that might look great on you might look way too large on a 5'1" friend who weighs 100lbs.  Objective measurements can be done to help ensure the right implant is chosen for the right individual. By trusting a board certified plastic surgeon, you will have the best chance of obtaining your desired results. Good Luck.

The goal of breast surgery is to create beautiful
breasts. Beauty is determined by several
factors and women often confuse breast volume with projection. As patients go to larger implants, the increase
in projection diminishes. For example,
the Sientra textured high projection implant that is 565 cc’s has 5.5
centimeters of anterior projection. An implant
half that size (approximately 300 cc’s) has 4.6 centimeters of anterior
projection. The difference is 0.9
centimeters, which is about 3/8th of an inch. A 3/8th of an inch increased
projection would not be noticeable on any patient even though the implant size
has doubled. A larger implant will not
give significant projection. Since you
have great breast tissue I recommend The Mini Ultimate Breast LiftTM
to reshape your breast creating upper pole fullness, elevate them higher on the
chest wall and more medial to increase your cleavage. Smaller implants are more stable long term,
less likely to displace inferiorly and laterally requiring revision. 22% of women who undergo breast augmentation
require a revision within 2 years because of dissatisfaction with the
results. Larger implants, such as you
have suggested, increases the probability of revision. Best Wishes,Gary Horndeski, M.D.

Based on some significant experience with a large number of patients who have undergone breast augmentation with “larger” breast implants, I do not necessarily think that it is the size of the breast implant that causes problems but the selection of a breast implant size that is TOO LARGE  for a specific patient's anatomy to accommodate. Utilizing a breast implant that is too large for a specific patient's anatomy exposes the patient to potential problems with breast implants displacement ( such as bottoming out), breast implant rippling/palpability… I hope this, and the attached link ( dedicated to “larger” breast implants) helps.