Double mastectomy: reconstructed with 800cc/high profile/gel/below muscle. Even with such a large implant, it's NOT close to my size before surgery. I have a large amount of rippling. Are there ANY custom made implants? I am only 26, and NEVER expected a mastectomy so young, so it's important to be as close to what I was before surgery: a 38DD. Now I'm a C. Ideally I want to be a DD again. I'm 5'5 160 lbs, large frame by elbow breadth measurement. can this be done? Or is this impossible?
Young Mastectomy Patient - 800cc. Can I Go Larger?
Doctor Answers 9
800 cc implants are the largest you can get. If you have some extra fat, liposuction can be performed and fat grafted to get you closer to your original size. Talk to your plastic surgeon.
You can not get lrger implants
You had very large implant already and the rippling you feel is due to the thinning of the skin. I would like to see pictures before mastectomy and after reconstruction. You may benefit from fat grafting to enhance your breast and also create cushion to lessen the feeling of the implant ripple.
Larger implant = more rippling
It is definitely a huge adjustment to have your own breast removed, then replaced with a reconstruction which can never look exactly like your prior breast. It is understandable that you want what you had before, but I'm afraid that won't happen in your case. You already have rippling with your current implants--a larger implant will only create more rippling and skin thinning.
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Breast reconstruction is a new reality.
I cannot begin to imagine what an enormous psychological adjustment you are trying to make after having undergone bilateral mastectomies at your age, and I understand completely your wanting to be close to what you were before.
But trust me when I tell you that bigger breast implants will not help you, either cosmetically or psychologically. You don't need bigger implants to improve rippling. Different shape or surface implants can help, Alloderm can help, and the skin-muscle pockets can be revised.
The larger the breast implants, the more fake you will look. And very large implants age very badly and stretch out your tissues.
800 cc implants
Unfortunately, 800 cc implants are the largest that the US manufacturers make. There are no available custom implants in the US
800cc Silicone Gel Breast Implants Are The Largest That Are Made
The largest stock silicone gel implants are 800cc, which you have. Custom breast implants are no longer made by any manufacturer. If 800cc implants only brings you to a C and you want a DD, then you would have to have implants that are at least 1200ccs if not larger. So even if a 900cc or 1000cc implant size existed, you would still be far away from your goal. This is a breast reconstruction result which can not be improved in size.
Breast reconstruction options for extremely large breasts
The largest size of silicone gel implants are 800cc. There is the option of an 800cc saline implant filled with greater than 800cc of saline, however, you are unlikely to have an implant reconstruction return you to your preoperative size/shape. In certain patients, a combined autologous reconstruction (ie. TRAM or DIEP flap) in addition to an implant can provide for larger size, however this is an unusual circumstance. Other options include fat grafting in stages to achieve larger volumes.
Implant Size in Reconstruction
800cc Silicone Implants are the largest implants that are FDA approved in the U.S.. For my patients seeking a silicone implant and a full look, I may consider the Allergan Style 45 implants that provide the fullest projection possible. If the 800cc Gel implant does not achieve the look you are seeking, then you may need to consider a saline implant. However, then you may experience more rippling. Another alternative would be to consider a form of tissue reconstruction (autologous reconstruction) +/- an implant. But in reconstructive breast surgery post mastectomy, there are limitations on what can be achieved.