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

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.

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