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

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.

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.
 

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