Do You Do XL Pectoral Implants?

Q: Dr. Eppley, I’m interested in getting larger pec implants than I had put in about 7 , 8 years ago here in NYC. I only have one in the right side, the left side developed fluid retention after surgery and had to be removed . Im interested in getting xxl larger implants. Questions: Do you work with larger size implants, how large do you think I can go safely and still get projection and a large lower chest…And, do you think I will experience the lymphedema on the left side again if I have another surgery? I understand there are better after surgery care for such co. Locations these days. 

A:In answer to your XL pectoral implants questions:

1) It would be helpful to know what size pectoral implant is currently in your right chest. (I assume it is a standard one and its size must be ‘small’ since your left chest does not look that different than your right chest) That would go a long way in answering the question of how much more implant volume you can get.

2) Because of the size of your natural pectoral muscles to get a more profound effect the pocket would have to be expanded beyond the lateral pectoral line. (see attached) In mosgt men in normal size pectoral implants that line is never violated but in XL pectoral implants it has to be and is usually the look the patient is seeking.

3) What you undoubtably had was a seroma of the left pectoral implant which often only resolves by implant removal. (which you had done) Seromas are a bit of a biologic mystery as no one knows why they occur exactly. There are the body’s response to the separation of tissue planes (in this case the pectoralis major muscle from the rib cage) and the lymphatic fluid leak that naturally occurs when that is done. This usually resolves quickly when the two sides fall back together which the placement of an implant between the two sides delays that process. Usually the body heals the implant pocket by the formation of scar tissue (capsule) which is uneventful. But in some patients for reasons unknown, the capsule persistently leaks fluid and does not stop. (aka seroma) As you had the same procedure done on both sides of your chest…one got it and the other side did not…why that occurs is not known) What is known is that once it occurs in an implant pocket the risk is higher that it might occur again. This is not an after care issue, it is an internal pocket issue.

Dr. Barry Eppley

World-Renowned Plastic Surgeon