Young Mastectomy Patient - 800cc. Can I Go Larger?

800 cc implants are the largest you can get.  If you have some extra fat, liposuction can be performed and fat grafted to get you closer to your original size.  Talk to your plastic surgeon.

Dr. ES

There is great news for patients whom have had breast reconstruction, but 800 cc is not enough projection or large enough to reach the size they were hoping for.  There are now 8 sites where patients can enroll in the Mentor "Large Ultra High Silicone Implant Study".  Implants as large as 1445 are available.  We have performed secondary revisions on multiple patients that needed a larger implant to fit their body and get the projection needed.  Finally we have a solution for patients unhappy with their reconstruction at 800cc.Mentor logo    
IRVINE, Calif., Feb. 16, 2016 /PRNewswire/ -- Mentor Worldwide LLC, a global leader in breast reconstruction, today announced that it has received a U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE) approval to initiate its ATHENA clinical trial. The trial is designed to demonstrate the safety and effectiveness of new sizes of MENTOR® MemoryGel® Breast Implants for breast reconstruction patients with larger chest widths, larger breast sizes, higher BMI or greater amounts of removed mastectomy tissue.
"There is a clinical need for breast implants larger than those currently available in the United States," said Dr. David Caplin, Board-certified Plastic Surgeon and President of Parkcrest Plastic Surgery Associates in St. Louis, Missouri.[1] "The size options for breast implants today are not adequate, especially when performing reconstructive surgery on large-breasted women diagnosed with breast cancer."  The largest implants currently available in the U.S. are 800cc.
Mentor expects to begin enrolling primary and revisionary breast reconstruction patients in the ATHENA clinical trial by April 2016. The ATHENA trial plans to enroll 600 patients at up to 35 sites nationwide and test implants manufactured using the same shell and gel as Mentor MemoryGel® Breast Implants. They will  range in size from 750cc to 1445cc.
"Obtaining IDE approval for the ATHENA clinical trial and the investigation of these larger implant sizes as part of the Mentor® MemoryGel® Breast Implant product family underscore our commitment to reconstruction," said Luis Davila, Vice President, Research & Development, Mentor Worldwide LLC. "We hope this study will contribute to a broader patient access to reconstruction surgery and address a long-standing patient need."  
As the leader in breast reconstruction, Mentor has launched multiple reconstruction solutions over the past 18 months, including new MemoryShape® Breast Implant styles and the ARTOURA™ Breast Tissue Expander. Mentor Breast Implants are backed by substantial clinical data demonstrating safety and effectiveness in primary augmentation, reconstruction and revision patients.[2][1] Dr. Caplin is a paid consultant to Mentor Worldwide LLC.
[2] Mentor Core and Continued Access studies for round and shaped breast implants.

Unfortunately, 800 cc implants are the largest that the US manufacturers make. There are no available custom implants in the US

The largest stock silicone gel implants are 800cc, which you have. Custom breast implants are no longer made by any manufacturer. If 800cc implants only brings you to a C and you want a DD, then you would have to have implants that are at least 1200ccs if not larger. So even if a 900cc or 1000cc implant size existed, you would still be far away from your goal. This is a breast reconstruction result which can not be improved in size.

The largest size of silicone gel implants are 800cc. There is the option of an 800cc saline implant filled with greater than 800cc of saline, however, you are unlikely to have an implant reconstruction return you to your preoperative size/shape. In certain patients, a combined autologous reconstruction (ie. TRAM or DIEP flap) in addition to an implant can provide for larger size, however this is an unusual circumstance. Other options include fat grafting in stages to achieve larger volumes.

800cc Silicone Implants are the largest implants that are FDA approved in the U.S..  For my patients seeking a silicone implant and a full look, I may consider the Allergan Style 45 implants that provide the fullest projection possible.  If the 800cc Gel implant does not achieve the look you are seeking, then you may need to consider a saline implant.  However, then you may experience more rippling.   Another alternative would be to consider a form of tissue reconstruction (autologous reconstruction) +/- an implant.   But in reconstructive breast surgery post mastectomy, there are limitations on what can be achieved. 

Unfortunately it is not possible to reconstruct breasts to be a DD. 800 cc implants are as large as they come. Special implants can be made, but I would not recommend it as it will likely lead to sagging, more rippling, and a poor overall result.

You had very large implant already and the rippling you feel is due to the thinning of the skin. I would like to see pictures before mastectomy and after reconstruction. You may benefit from fat grafting to enhance your breast and also create cushion to lessen the feeling of the implant ripple.

It is definitely a huge adjustment to have your own breast removed, then replaced with a reconstruction which can never look exactly like your prior breast.  It is understandable that you want what you had before, but I'm afraid that won't happen in your case.  You already have rippling with your current implants--a larger implant will only create more rippling and skin thinning. 

Hi.

I cannot begin to imagine what an enormous psychological adjustment you are trying to make  after having undergone bilateral mastectomies at your age, and I understand completely your wanting to be close to what you were before.

But trust me when I tell you that bigger breast implants will not help you, either cosmetically or psychologically.  You don't need bigger implants to  improve rippling.  Different shape or surface implants can help,  Alloderm can help,  and the skin-muscle pockets can be revised.

The larger the breast implants, the more fake you will look.  And very large implants age very badly and stretch out your tissues.