Breast augmentation with extremely large implant sizes has increased problems compared to choosing smaller or more natural implants. Many woman wanting larger, fuller, and more attractive breasts decide to proceed with enlargement. It’s extremely important to pick the size that makes you happy. There are many different sizes available with extremely high success rates and low risks. However, if we want extra large breasts, and we pick too big, it’s important to understand there is an increased chance of problems. This topic is reviewed in detail in this educational writing. I wrote this at the request of a patient from Philadelphia, PA.
The above photo shows a successful result from extra large implants. But it’s important to learn about this procedure and the risks. During my consultations, I work closely with my patients to give them a thorough and extensive consultation. I also work extensively with each and every woman to help them understand the concepts about enlargement and to help them choose the best size implants. Choosing size is one of the most fun parts of the process. It, however, can be difficult and anxiety provoking for some. It’s important for the patient to work hard and diligently on this decision. I call it doing your “homework.” Click here to another educational writing reviewing homework for breast enlargement.
My consultation will review in detail problems and risks associated with augmentation. The decision to go too large can actually increase the chance of certain problems. The main problem associated with extra large sizes is shape issues. With any size breast implant, an important point to understand is there is a risk of developing problems with shape. This means a problem with abnormal appearances of the breast. This risk is low, but it needs to be understood. What would shape problems look like? Implants can heal too high, or they can heal too low. The breasts can be different from each other, called asymmetry. Sometimes “double bubble” shapes can occur. When implants heal with poor shapes. Surgery can be required to correct the problem.
Larger breast implants have higher risks with shape issues compared to more normal sizes. I will explain it to my patients in the following way. If a person chooses implants the size of basketballs, don’t you think there would be increased shape risks? Most people will intuitively say, “Yes.” If we put in cantaloupe size implants, there would again be the increased problem with abnormal shapes. Small and more natural implants have lower risks and higher success rates.
Larger size implants also have increased risks of rippling and feeling the implants. The bigger sizes stretch out and thin the existing breast tissue. This happens to a much greater degree than with smaller implants. This thinning out of the tissue leads to what is called poor soft tissue coverage. In extreme cases, the tissue is so stretched out that it’s just a thin layer of skin covering the implant. In this case, it is much easier to see and feel the implant. Seeing the implant is called rippling, and feeling it is called palpability. Larger implants have a higher risk of tissue thinning and poor soft tissue coverage. Implants are purposely placed beneath the muscle to minimize this problem or risk. However, large implants even beneath the muscle will have more rippling and palpability than smaller ones.
What is the Safest Larger Size?
A common question I am asked is, “What is the largest size I can safely choose without increased risks?” Unfortunately, there is no set answer to this question. One doctor did an extensive study and concluded it was 425 cc. But this is an oversimplification. There is no absolutely safe number. It’s more important to understand that at some point the bigger we go – the higher the chance of problems. In my experience, I have found that 500 cc is often the upper limit of safety. But even this volume varies. A women who is 5′ 2” and 110 pounds might need to choose smaller. A women who is 5′ 10” can potentially choose larger sizes up to 600 cc, depending on her measurements.
“I Know I Want Extra Larger Sizes like DDD or XL Breasts. What Can I Do?”
If we know that the goal is extra large breast sizes, then the answer is a staged approach. Staging means planning on more than one operation. Usually two operations are done to safely get an extra big result. This will allow the maximum size with silicone and will get us up to 800 cc, which is the largest silicone implant manufactured. This approach has definitely lower risks and problems than a single operation where huge implants are placed. Staging allows for the first operation to stretch the breast and tissues to a safe and reasonable amount. The second operation can more safely place the larger sized implant to give the look we are desiring.
Some patients want even larger than 800 cc. This situation might require a third (staged) operation. There’s simply a limit to how big you can go in two operations without ripping the tissues or causing other problems. The extra stages allow for increased safety and to slowly stretch the tissues. Implants larger than 800 cc must be saline. The saline implants can be overfilled to extra large sizes. The picture below is of a patient who desired a large size. The first stage was 500 cc. The second stage was to 1000 cc. The third stage was to 1500 cc. This allowed for an excellent result with safety. The largest implant I have placed is 2300 cc!
Larger Sizes Hurt More During the Recovery Period
The physical and anatomic stretching of the muscle and the breast lead to increased pain during the recovery. Smaller implants have an easier and less painful recovery. I will tell my patients how great the Pain-Buster is to decrease pain. The machine slowly delivers numbing medicine to lessen the pain after surgery and to quicken the recovery. But extra large implants can make the pain tough even with the Pain-Buster. Large size implants hurt more than smaller implants. It is a factor related to the physics of squeezing in bigger implants under the breast and muscle, leading to increased stretching of the tissue. Click here to visit the Pain-Buster for those interested in more information on this topic.
For those patients interested in breast augmentation or those choosing large sizes, please come in for a thorough consultation. I will review the topic in detail with you, and I will help you get the size you desire in the safest manner.