Currently have 750cc silicone and wanting to go between 1400 to 1800cc. Do you think that’s to big for my frame? (photo)

Question

Xl breast implants  - Schedule to get implants the end of October. Currently have 750cc silicone and wanting to go between 1400 to 1800cc. Do you think that’s to big for my frame.

Gary M. Horndeski, MD · Answer

1800 cc implants correspond to a diameter to 19 centimeters.  Your chest width has to be 38 centimeters to accommodate these.  If your wall is less, the implants will not have lateral support and will displace requiring revision.  1800 cc implants weigh almost 4 lbs each.  You are adding 8 lbs onto your chest wall, which your neck, back and shoulders will have to support.  Insurance companies authorize reductions for amounts less than that out of medical necessity.  I think this would be a mistake.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear mhatt12345,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

Donald R. Revis Jr, MD · Answer

Good morning!I perform over 200 XL overfilled saline augmentations a year, so as opposed to most of the answers you are likely to receive that it's a bad idea, I can tell you that it is successful and patients love them. Unfortunately your photos are not far enough away for me to see your entire chest to evaluate what size you are likely able to achieve or can hold. In my office I have you try on implant sizers over your current implants, we review photos together, and in the O.R. I will fill as close to that goal as possible while not reaching a point where it is not safe or the risk of complications increases. Generally if you are currently at 750cc then 1400cc is not out of the question at all but 1800cc would be unlikely in one surgery but could be reached in two.

Don Fontana, MD · Answer

You need a  thorough physical exam. Do you want to regret this large an augmentation now or later in life ?  I would avoid this. As you age, your skin ( and back, cervical spine) will not tolerate the added weight of the implant resulting in marked stretching and stretch marks. There is frequently a misalignment/asymmetry  of the nipples. If you have it done, be certain that the operating surgeon is willing to address the late term problems that you could encounter.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Mhatt12345,Hello and thank you for your excellent question. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. The size, profile, shape, texture, and type of implant (e.g., saline, silicone, “gummy bear”) is based on your desired versus existing breast size and shape, your chest wall measurements, and soft tissue quality. It is essential that you have an in-person consultation to develop a treatment plan that specifically addresses your personal surgical goals, and your body’s anatomy. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018

Currently have 750cc silicone and wanting to go between 1400 to 1800cc. Do you think that’s to big for my frame? (photo)

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