Background: Breast implants are available in a wide variety of sizes based on volume. (ccs) Implant size ranges from 150cc to 800cc for most manufacturers. The vast majority of women achieve their breast augmentation goals in the median of these numbers in the 300cc to 500cc range. Large breast implants would be judged by most patients and plastic surgeons as in the upper ranges of 650cc to 800ccs which are used in a minority of breast augmentation patients who seek a very large result.
There is, however, a very small minority of women who seek very large or extreme breast augmentation results. The breast implant volumes needed for this type of breast augmentation result is north of the maximum standard size of 800ccs. At these volumes the choice becomes a saline implant rather than a silicone-based one. Although the base size of saline breast implants does not exceed 800ccs, they can be overfilled to well over 1,000ccs. The maximum volumes for overfilling saline breast implants are not precisely known but 1,500 to 2,000 seem to be capable of being tolerated by the implant shell. At the least 800cc to 1200cc is well within their capacity.
Extreme breast augmentation is almost always a staged approach. Rarely does or can a woman go from no breast implant to one over 1,000ccs. The breast tissues must be expanded with one or two prior sets of implants to tolerate such extreme implant volumes. It is also important to understand the implications of such large breast implants which can include severe breast tissue thinning, implant bottoming out and what the breasts would look like should the implants ever be downsized or removed.
Case Study: This 35 year old female wanted larger breast implants. Over the past seven years she had two prior sets of breast implants which became increasingly larger in volume. Her existing breast implants were smooth round silicone implants of 675cc volume.
Under general anesthesia she had her existing silicone implants removed and replaced with 800cc smooth high profile saline implants. They were filled to 1,100ccs on each side whose volume created a breast lifting effect as well as a breast size increase.
Very large or extreme breast implants do create considerable breast size. But because they are saline implants such overfilling will make them feel very firm. They will not feel soft or supple like silicone implants. They will also sit very high with a very round upper pole fullness, an unnatural look by most breast augmentation standards. But a look that is preferred by the women who choose an extreme breast augmentation result.
Highlights:
- Extreme breast augmentation is classified as any implant volume over 1,000cc and always involve the use of saline breast implants.
- Such large volumes of breast implants always occurs as a subsequent breast implant replacement and not achieved in a single stage augmentation in most cases.
- Large breast implants are usually best done through an areolar incision to guard against pressure on the incision site.
Dr. Barry Eppley
Indianapolis, Indiana