Are there silicone breast implants available at 1000cc, for reconstruction after double mastectomy?

Question

Due to my measurements I need to have implants of 1000cc. I want silicone and have been told by my DR. that 800cc is the largest available, that I would have to have pinning on my sides to hold them. I have 800cc expanders in now with a 4/5 inch gap in front where I should have cleavage. I look like a science project. I had a double mastectomy in Feb. due to cancer. I am a larger women and just want to look more normal. Please Help!

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.The largest silicone implants are 800cc. I typically use fat grafting to fill out the breast and other areas. The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

Alexis L. Parcells, MD · Answer

Great question. 
Unfortunately the largest silicone gel implant being manufactured is 800cc. However, it is possible to overfill a saline breast implant to upwards of 1000 cc. 
You may benefit from the use of ADM, or acellular dermal matrix, to assist in shaping your breasts into a more aesthetic position.
I recommend seeing a board-certified plastic surgeon in consultation to learn more about your options.
Good luck!

Tracy Kayan, MD · Answer

On a very rare occasion a larger custom silicone implant can be made, but I have never used one or seen one used in breast reconstruction. Your options would be to go with a saline implant or you can go with an 800 cc silicone implant and then use fat grafting (may need more than 1 round of fat grafting) to round out your cleavage area to help your breasts look closer together. Also, your implants will look a lot different than your expanders do now, so don't let your current appearance discourage you too much. There are 800 cc implants that come in different widths, so if your surgeon can tend toward a slightly wider one, that will give the appearance that your breasts are closer together.

Mark Deutsch, MD, FACS · Answer

Yes, unfortunately the largest gel implants available are 800 cc. You could have a saline implant placed that could be inflated above 900 cc or you could have the 800 cc gel implant with fat grafting for contour improvement. It is best that you discuss your concerns with your plastic surgeon.

Paul Gill, MD · Answer

Thank you for your question.   There are ways to reconstruct women with a larger frame.   3 basic options:1.  If your BMI is less than 40 and your health is otherwise good, you may consider using your own tissue in  a DIEP flap procedure.   This will give you the volume you desire.2.  Placing 800 cc silicone and doing 1-2 fat grafting sessions to add volume and shape over the implant.3.  Saline Implants can be overfilled to 1000 cc but the aesthetic result is the poorest with rippling and a more unnatural feel.   However, it will fill the bra in clothing wellAll the best.Dr. Gill

Tracy E. McCall, MD · Answer

There are three companies making implants in the US marketplace, Mentor, Allergan, and Sientra. None of these have a readily available implant over 800cc. You may be able to get a custom, but that is something you'd have to talk to your surgeon about. I am not sure what you mean by pinning on your sides. Are your expanders sitting too far to your sides? The surgeon will likely adjust the pocket so that the implants are more appropriately situated.I think your main compliant right now is that you don't like the look of the expanders. This is often the case. They are hard and they look like big balls sitting on your chest. The two sides don't always expand the same way so sometimes you see some pretty significant differences. Most women don't like the expanders and I would agree that they don't look very good. The surgeon usually gets some significant improvement going to the implant. I do like the silcone, they are softer and would be my choice in your situation. I've reconstructed a number of larger women--both tall and/or heavy. The 800cc implant does a nice job. You may not be as large as you were before and you may not be busty, but you can get a mound out of it to make a nice reconstruction.

Samir Shureih, MD · Answer

I believe Mentor company has a silicone gel Moderate profile plus of 960 cc volume and a diameter of 15.5 cm. and projection of 7 cm.The cleavage would depend on the chest wall shape and the width of the breast bone,Remember that the larger the implant the more the complication. Large implants require a good amount of soft tissue coverage. Large implants, due to the weight, can displace very easy.There are other options is to use a Latismuss Dorsi Flap and a smaller implant. This will add the volume of the latismuss Dorsi flap plus the volume of the implant. The Latismuss muscle can support the implant, stabilize the inframammary line and use of Acellular matrix at the lateral aspect . This will decrease the risk of displacement of implant. Other options to consider are autologous flap reconstruction with or without adding an implant. Such procedures may also correct for the cleavage line.

Are there silicone breast implants available at 1000cc, for reconstruction after double mastectomy?

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