LARGE breast implants: breast augmentation (photos)

Large breast implants? I really do appreciate the question that you’re proposing about large breast implants! Large breast implants can be highly gratifying to a small subset of women who are looking for extremely large breasts However, it is well known that the larger the implants the greater the risk of having revision surgery to keep those large breast implants will be in the future. There is no doubt in my mind, that having extremely large breast implants and accomplishing your goals will make you happy but the most important question I ask myself is how long will this patient be happy for? I discuss this point with all of my patients who wish to have extremely large breast implants before committing to surgery. You will find that there are many qualified plastic surgeons who can do a very large breast implants, but I think you should discuss with them when you go for your consultations your expectations for revision surgery and the overall costs of maintaining very large breast implants In your life!Wishing you a wonderful future, Dr. Aldo

Thank you for your pictures and questions. There is no plastic surgeon out there with special expertise and training in "large implants." If you find someone who is advertising this or trying to say they have special expertise, I would not go to that person. Any plastic surgeon who is board certified by the American Board of Plastic Surgery can help you discuss your goals and pick what would be right for you. The first thing you need to know is that implants only go up to 800 cc and if you want to go larger than that, you would need to choose a saline implant and have it "overfilled" to over 800 cc. It may be possible that your frame and breast measurements would accommodate an implant that large but a consultation would be needed to determine that. Usually implants that large are very wide and most women are not able to have a wide implant without causing poor results. You also may need a highly projecting implant to achieve your goals which can look somewhat unnatural. The reason most surgeons do not "like" to place large implants in patients is because often it is the wrong choice for that patient and despite what the patient thinks they want in terms of cc size, that actual implant will not fit them properly and give a good result. In addition, large implants have significant weight and often age poorly, requiring frequent and premature revision surgery which comes at a significant increased cost for the patients, not to mention eventual dissatisfaction and poor cosmetic outcomes over time.Hope this helps! 

Thank you for your question.  It is certainly possible to place large implants but there are some things to consider:
1.  Some patients have a larger frame and can more readily accommodate larger implants as an initial surgery.
2.  The larger the implant is relative to the breast base dimensions, the less support there will be for its weight - particularly laterally and inferiorly.
3.  Depending on the position of your breast tissue relative to the underlying muscle as well as skin quality and natural upper pole breast tissue thickness, you might be better off with a subglandular pocket as opposed to submuscular.  There are tradeoffs with this.  A frank discussion with your surgeon is best and there are always compromises with any decision that is ultimately made.
4.  Some patients will have a better long term result if the procedure is staged.  What I mean by this is placing an intermediate 400-600 cc implant initially and planning to swap to the larger size later once the pocket has stabilized around the smaller volume.  This allows greater predictability and pocket positional control.  In my practice this group of patients has had the least amount of long term issues.
5.  Patients with tight lower poles (short nipple to fold distance) are particularly challenging with larger implants since the skin has to stretch so much to accommodate the lower half of the implant.  The degree of stretching varies on multiple factors and can be difficult to achieve or control despite the best effort on everyone's part. 
In your specific case, you are tall and have what sounds like a good starting breast shape.  You might do just fine with large implants in a single stage.  I would find someone well trained and qualified in your area and have a thorough discussion including their experience with large implants as well as their policy for re-operation and revision if needed.  There are definitely more issues with oversized implants and this is perhaps why many surgeons prefer to stay more conservative with the services they provide.