I have DD ultra high under the muscle silicone breast implants. I want to go bigger to like 600/800 silicone ultra high. Advice?

Question

What is the best way to do this? Would it be good to get an internal bra? What is the best to keep them high and fake looking? Are there special doctors in the OC Cali who I should go to?

Robert W. Kessler, MD, FACS · Answer

Thank you for your question.The decision to go bigger involves from a technical standpoint will require an in person consultation.The current appearance and dimensions of the breast as well as the relationship of the breast and chest wall to the implant need to be evaluated and understood.Given you have large implants already the capsule and space are well defined. If the implants are soft and mobile there most likely will already be space for a larger implant. Given you have the most projecting implant profile the only way to get larger would be to increase diameter. Depending on your aesthetic fat grafting to the upper pole of the breast may also be done to further enhance volume.There are potential negatives to larger implants which must also be discussed and understood before moving forward.Seek out a board certified plastic surgeon with experience in revisionary breast surgery. I would also encourage you to bring images of your desired breast appearance. Images of breasts you do not like are also helpful for your surgeon to truly understand your aesthetic.Good luck and I hope this was helpful.

Robert M. Kachenmeister, MD · Answer

Thank you for reaching out! I would suggest visiting a few experienced surgeons for in person consultations. A lot will depend on your size, current pockets etc. Nothing can replace an in person consultation! Best of luck! Dr. Kachenmeister

Milind K. Ambe, MD · Answer

In order to answer your question it would be best to at least see photos.  Going larger often makes it more difficult to stay high and round on top, simply due to gravity.  You might consider reposting this with some photos of you and your desired result. Best of luck to you

Tom J. Pousti, MD · Answer

Thank you for the question. You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile. Having said that, it is generally necessary to utilize high or ultra high-profile silicone gel breast implants or overfilled saline breast implants to achieve the types of outcomes you describe.  Adjustment of the breast implant capsules (capsulorraphy) will also be necessary.
Ultimately, careful selection of plastic surgeon and  careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical. 
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “high and fake” or "DD cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.
I hope this, and the attached link (dedicated to "larger" breast augmentation surgery concerns), helps. Best wishes.

Marcel Daniels, MD · Answer

Bigger=heavier=more tissue stretch. The only way to keep them high and fake looking would be to have a capsular contracture which is some cases is painful. Be careful what you wish for!

Arian Mowlavi, MD, FACS (license on probation) · Answer

in order to have fake looking breasts, you have to make sure that the upper aspect of the implant is going to bulge out of your bra; this requires larger implants than the average breast aug patient; now whether you should get a 600 or 800cc implant, is based on your breast dimensions; this requires a measurement of your chest width as well as taking into consideration where your nipples are positioned. Remember, the nipples need to be centered on your implant; if the nipples are too low for the implant chosen, you may also need a lift.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and I would go on complimentary consultations  with experts and compare recommendations after a full examinationDr Corbin

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

The fake breast look can be achieved in several ways, depending on what you want your eventual size to be. If you want to have less than 1400cc XL breasts, then I do 800cc saline implants(largest shell size available in US) and overfill them. If you want to be largerr than that, then I recommend my XL custom tissue expanders which can be filled to much larger sizes. At same time you may need some type of uplift. I recommend that you visit my site esp for XL breast implants for further explanation of different alternatives. My specialty for many years has been XL breast implants. I also recommend that you go to a plastic surgeon that has extensive experience in these sizes to get the best results for problems can occur and more frequently. I also do revisional surgery on XL patients. I offer SKYPE/FACETIME/What'sUp consultations which can be arranged through my XL patient coordinator(Rachelleatsurgery-plastic.com).

Ronald V. DeMars, MD (Retired) · Answer

We can't give you much information without photos and DD is not an implant size so we really don't have a lot to go on. Just remember ultra high does not mean high on your chest, it means the implants stick out a long ways in front of you. They do not go as high on your chest as a similar volume low or moderate profile implant that will have a larger diameter. Patients frequently don't understand that. Also the larger the implant the more the weight and weight goes down, not up.

Jon A. Perlman, MD (retired) · Answer

I'd advise you to keep in mind that in time, gravity and skin stretching is unavoidable especially with very large implants.  With settling and stretching will you possibly seek even larger implants?  It becomes a slippery slope IMHO.  Think this over carefully and watch the video link above for my thoughts about very large implants and their impact over time.  Best wishes....
Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Extreme Makeover Surgeon ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

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