How much Increased risks from 700 to 800cc silicone implants?

Question

I’m 5’8” 220lbs, very curvy on the bottom but have small breasts (no sagging at all currently). I initially wanted 650 or 700cc silicone under the muscle.... but my plastic surgeon suggests 750 or 800cc silicone implants “to better fit my frame.” How much increased risks if I go with 800 instead of 700? I’m worried about extreme sagging. I plan to wear a bra every day and overnight.

Kenneth Hughes, MD · Answer

Tall women with large frames and broad chests, shoulders, and hips can often handle larger implants that would make smaller women's chests look overcrowded and heavy. Realize that implants of 600cc and higher will lead to more tissue thinning over time, have more potential for rippling, more potential for bottoming out, greater likelihood of breast lift revisions because the breast tissue and skin may not be able to support them. What constitutes too large of an implant is generally thought of as one whose base diameter is much greater than your natural breast base diameter.

Caner Kacmaz, MD · Answer

Breast implants are sized according to their volume in cubic centimeters (cc).

How do you know what size implant to choose? Looking at pictures and talking to friends who had a breast augmentation might help.

Off course the volume will depend on the shape and size of your actual breasts, your frame and the size you want to achieve.

Our plastic surgeon will advise you thoroughly. Bringing pictures of a desired restult to be shown to our surgeon, might be very helpful.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not told us your bra size or provided photographs. However, 700 & 800 cc implants weigh over 1 1/2 lbs each. This may result in neck, shoulder and back pain. Also, the only thing holding up the implants is the skin envelope which will not be able to hold up these large implants long term. They will descend inferior and laterally and you will eventually need a lift or removal of the implants. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Implants this large will never fit underneath the muscle.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear anyway47,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ali Gurlek, MD · Answer

Thank you for your Question. 
there are multiple factors influencing the actual size increase a breast implant will provide other than volume, including:
Implant profile (projection) and base widthImplant shape (i.e., classic round, teardrop shaped, extra upper pole fullness)How much natural breast tissue you haveThe width and contour of your rib cage

Connie Hiers, MD, FACS · Answer

You are choosing a very large and heavy implant that will thin your tissue over time, may be too heavy on your neck and shoulders and sag. Once healed, please do not wear bras at night while sleeping because this can increase your risk of breast cancer.

Raj Ragoowansi, MB, MSc, FRCS (Plast) · Answer

This size of implants is large and even without the benefit of assessing you in person, I can tell you that these kind of volumes will render your breasts droopy, with stretch marks in the future.In your scenario, I would strongly suggest not to go up in volume any further.

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