What Big Can A Large Breast Augmentation Go?
Q: Dr. Eppley, I am interested in extremely large breast augmentation. How big of breast implants do you do? I currently have 1200cc saline implants, under the muscle. Recent surgery done late last year. I realize I’m not done healing and I can’t have a revision for some months down the road, but I would like to at least double in size. I’m shooting for the 4000cc range one day. I’ve heard some surgeons say these sizes are not possible. My first surgery I’m not happy with, I was hoping for more roundness and projection. Please let me know if this sounds like a surgery you think you are capable of. Thank you
A: When it comes to extremely large breast augmentation, it is not a question of capability but implant possibility. Extremely large breast implants require that they be saline and overfilled. The largest U.S. manufactured FDA-approved saline breast implant is 800cc of which the manufacturer recommends a maximum fill of roughly 1000ccs. But they can be safely filled to more than that as your case illustrates. How far beyond that one can safely go has never been studied and is not scientifically known.The physical characteristics of the implant when filling to saline volumes of 2000cc or more with base sizes of 800ccs involves issues of rupture potential and extreme hardness of the implants. When it comes to filling to 3000cc or 4000ccs that is not going to be possible with any FDA approved saline breast implant.
While larger base size saline breast implants exist outside of the U.S., the vast majority of plastic surgeons are not going to risk their medical license by illegally importing in non-FDA approved foreign medical devices.
It is clear in looking at your pictures that you have a lot of breast skin and it has the capability of even great volumes than 1200ccs. And as a general rule, you do have to increase your volume by at least 50% to see an appreciable size difference. But a greater overfill than that is probably not going to be tolerated by the implant shell without a significant risk of rupture.
Dr. Barry Eppley