What Size Implants Do I Need For Extreme Breast Augmentation?

Q: Dr. Eppley, I am interested in breast implant replacements. I currently have 400cc saline breast implants in and the plastic surgeon I went to suggested replacing them with 650cc smooth round silicone implants. Based on where I am now and where I want to be (I attached a bunch of ideal breast augmentation results) I do not think he and I are on the same page. I don’t think he understands what I mean when I say extreme breast augmentation. Can you look at all my pictures and tell me what you think. Your reputation as a plastic surgeon precedes you so your opinion would mean a lot to me. Thanks!

A: Thank you for sending all the photos of your breasts and that of your ideal result. Based on how your breasts look now with 400cc implants and their degree of sag and nipple position, none of those ideal results are achievable for your breasts. Your breasts have too much skin and sag to look that high up on the chest or to be that round…regardless of the size implant used. All that can be done is to make them bigger and somewhat more round but getting enough implant volume in place is the key. It is clear to me with these goals that 650cc is not going to adequate. more likely it is somewhere between 800ccs and 1000ccs to be able to fill out your breasts for a rounder fuller look. No silicone implant is made over 800ccs and its weight will make the breasts bigger but not as round as you would like. Only overfilled saline implants will create a more rounder effect as they naturally sit higher and rounder when overfilled. Most likely an 800cc saline implant filled to 960cc to 1000cc will be needed. It would also be important to use an areolar incision when placing such large breast implants to keep the incision at the top of the mound and away from the skin stretching effects as the base of the breast mound. Anytime one gets over 800ccs in implant volume that would fall into the classification of extreme breast augmentation or the use of very large breast implants.