Q: Dear Dr. Eppley, I would like to replace my existing saline implants which are now 10 years old with new ones. The original size was 800cc shells filled to 960cc which I was told was the maximum fill at that time. My annual mammogram is coming up and I worry about my decade old implants failing under the pressure (yes I know it is a remote possibility, but I still am concerned). In doing a replacement, I want much larger implants. It would have to be done with either custom made implants or largely overfilling the largest saline breast implants that are made. In doing a replacement I would want a lot more volume than 960cc with as much as a 200% fill to give me more upper pole fullness and more projection. In effect a “mastopexyless” breast lift (had one masto, don’t want to do it again). There are several surgeons in US who are doing very large fills of 800cc saline shells at a patient request. Fills of 1400cc to as high as 2000cc are documented in various internet implant breast forums.
A: While available at one time, custom breast implanrs are no longer made by any US manufacturer. Neither breast implant manufacturer will custom make any implant size at this time. The largest off-the-shelf saline implant are still 800cc of which the manufacturer recommended maximum fill is 960cc. (which you obviously know) The 800cc imlants only come in moderate plus projection. (Mentor) What any plastic surgeon is willing to fill to beyond the recommended fill is between the surgeon and the patient. Beyond the manufacturer’s recommended maximum fill, the patient risks losing the lifetime implant replacement warranty from the manufacturer. Nobody knows for sure how much overinflation affects the potential for deflation or rupture, although it may be fair to say that it has a negative influence. As the implant becomes highly overinflated it also becomes quite hard and unnatural feeling. These are all issues that a patient needs to consider when requesting and/or receiving high volume overfills.
I have heard rumors that the manufacturers have requested from the FDA approval to manudfacture and sell larger breast implant sizes than that which is currently available. (I can not verify that this is true) So larger implants with a base size over 1000ccs may be available in the future.
Dr. Barry Eppley