Can I Get An Extra Large Breast Augmentation?

Q: Dr. Eppley, I am interested in extra large breast augmentation. (technically extra large breast implant replacement. Can we do a consultation via email since I live far away. I want 1000cc implants. I currently have 500cc on right breast and 400cc on left and clearly they are not even close to being as big as I asked for. The dr was more concerned about doing what he thought looked best and not accommodating what I wanted at all. It is humiliating as they look awful. This is not remotely the size I was looking to get.

A: The concept of extra large breast augmentation is controversial amongst plastic surgeons. There is a large group of plastic surgeons who choose breast implants based on their assessment of the breast tissues to support them over the long-term. With this concept they do not put sizes that are wider than the patient’s natural breast base diameter or the less measurable quality of the support of the overlying breast tissue/skin sleeve. For many patients this means that sizes less than 400ccs are placed. There is another group of plastic surgeons, arguably smaller, that provide any breast implant size that the patient wants including very large sizes. These implant sizes do irreversibly stretch out the breast tissues and are more prone to bottoming out over time (loss of support) but do meet the patient’s expectations.

What your initial breast augmentation result was less than you wanted, your plastic surgeon probably placed implants that he felt comfortable could be adequately supported by your breast tissues. He or she was looking out for some long-term issues that most patients are understandably not aware of.  This may have been too conservative for you but was a safe approach. The good news is that this is an improveable problem, albeit with another surgery, and larger implants can be placed. You also have the advantage of now knowing what implant size may be acceptable since you know what size change has occurred with the volume you now have in. It is now about volume ratios. If you want a breast size that is twice as big as you now have, you will need a 100% increase in the implant’s volume.

Dr. Barry Eppley

Indianapolis, Indiana