Silicone implants larger than 800cc for tall, very broad shouldered women

Question

I get that silicone implants in the US are limited in size for certain women but those laws don't take into account women who are six feet tall with very broad shoulders. I'd be well equally sized with many men. I have 850cc saline implants overfilled to 1000cc but they're too hard and still don't quite fill my chest the way I want. What can I do?

Gerald Minniti, MD, FACS · Answer

Hello,The Mentor Corporation will be releasing implants larger than 800 cc in the near future. So, it is best to wait. Best of luck!

Tim Neavin, MD · Answer

The ways your concern is often addressed is wither with doubt stacking breast implants or with the addition of fat transfer.  Be sure to see a board certified plastic surgeon since both of these methods aren't conventional approaches to breast enhancement.

Jonathan Saunders, MD · Answer

sorry to say there are no bigger implants available. I have mentioned this quite often to my rep and we will see

R. Laurence Berkowitz, MD · Answer

You are of course correct that implants are meant to be sized in proportion to the subject. You may fall outside the usual guidelines. Waiting for additional sizes in today's regulatory climate may frustrate you.  Fat grafting will help assuming you have sufficient donor sites.  The fat can be added to the pectoralis muscle which will hold the fat well.  In addition it is my opinion, shared by many of my experienced colleagues, that implants this big should be reinforced underneath with a biologic mesh such as Strattice or perhaps Galaflex. Strattice has the additional advantage of helping to prevent capsular contracture. Proper sizing based on base dimensions and desired projection which can be demonstrated with imaging should help you

H. Daniel Zegzula, MD · Answer

There is an ongoing clinical trial of large volume silicone gel breast implants using Mentor implants.  These "Athena" breast implants were cleared for investigational use by the FDA for breast reconstruction patients.  Implants sizes go up to 1400 cc.  Since you currently have saline implants and have an unacceptable result you may be considered a reconstruction patient for the purposes of the study.  We are a study site here in Portland but you should seek out a board certified surgeon in your area that is participating in the study to see if you qualify.

Michael F. Bohley, MD · Answer

Thank you for your question. Believe me that there are many in the plastic surgery community who share your frustration. There are many breast reconstruction patients in my practice who would benefit from the availability of larger volume implants. As you've stated, 800cc is just not enough for a woman with a larger frame/wider chest. Implant augmentation can be combined with fat grafting to add additional volume and softness. Until we get larger gels to use, this may be your best option. I would discuss this, and other options, with an experienced board certified plastic surgeon in your area.

Connie Hiers, MD, FACS · Answer

In the US, the largest silicone implant available is 800 cc's, and the largest saline is up to 1000 cc's. The saline implant can be overfilled some, but this can cause more rippling and hardness. You can possibly improve your size with fat transfers. Also, if you choose, flaps are available for breasts. Most of the flaps are done as reconstructive procedures. I would suggest meeting with a board certified plastic surgeon and discussing all your options.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns and they are quite understandable.  Unfortunately, there is no perfect product, at least in the United States, for patients who would benefit from larger breast implants. In my practice, I have had the most success in these situations using overfilled saline filled implants.  For most patients, these implants tend to soften up ( to some degree) over the course of several months.  You may find the attached link helpful to you as you learn more. Best wishes.

Edward J. Domanskis, MD (in memoriam) · Answer

I have specialized in XL breast implants for many years. I have a special arrangement with a couple of breast tissue expander companies as well as custom XL silicone manufacturer and have offices in California/Miami/Nassau/ANGUILLA AND ITALY. Some of my patients have gone well beyond the size that you wish to be! I woiuld suggest you visit my website specifically for XL patients below.I am available for FACETIME/SKYPE/Whatsup video consultations.

Silicone implants larger than 800cc for tall, very broad shouldered women

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