Will U.S. surgeons give me XL breast implants?

I know it's frowned upon but it's my business and I KNOW I want XL (extra large) breast implants. Will I be able to get this surgery in the U.S. or will I have to take my chances and my business elsewhere? Is there a legal limit for breast size that U.S. plastic surgeons are not allowed to go beyond? I think it's stupid if that's the case. I'm over 18 and I know what I want and that should be all that matters. And that I have the money to pay for it. That's all that should be required.

NightWonka

F, 21, Kentucky

Helping patients achieve their cosmetic goals is a very satisfying part of any plastic surgeon's job. However, all surgery carries with it a certain degree of risk and it is the surgeon's responsibility to ensure that the patient is thoroughly made aware of any possible complications or issues that may arise as a result of their procedure.

In the case of extra large breast augmentation surgery, there are unfortunately a number of issues that can occur if a patient has oversized implants placed in their body. Because of the correlation between increasing implant size and possible complications, there is a restriction in the United States on extra large breast implants. 800cc is currently the largest implant size available. Implants larger than this are more likely to result in complications, such as:

  • Bottoming out or dropping out, which occurs when the implants
  • Rippling or visible implant wrinkling
  • Poor longevity
  • Capsular contracture, where a hard shell forms around the silicone implant
  • Back pain
  • Issues with implant placement
  • Difficulties with physical exercise
  • Excessive tension placed on the incisions

In addition, your own anatomical specificities will influence the size of implant that you receive. Breast and chest width, as well as skin and tissue laxity will limit the size of the implant.

The larger the implant, the heavier the volume, the more stretching required of the skin. Skin that is too tightly stretched over oversized implants looks unnatural and makes the implants themselves more palpable or easier to feel under the skin.

Essentially, if your implants are too large for your body, you are less likely to enjoy long-lasting, aesthetically beautiful results and more likely to suffer from complications of some sort.

I suggest you find a caring, board-certified plastic surgeon and explain your goals. They will help you to find the right implants to suit your body frame and take into account the elasticity of your breast skin and other important factors.

Bear in mind that many plastic surgeons have 3D-imaging software available in their offices to allow you to get a good idea of how implants will look on your body type: you may be surprised to find that a high profile 600cc implant provides a significant enough increase.

Dr. Kimberly Henry has 4 Breast augmentation before & afters:

Breast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly HenryBreast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly HenryBreast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly HenryBreast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly Henry

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Plastic surgery transforms your body and also your life, so it is essential that you are as informed and as knowledgeable as possible about the effects of extra large implants before you commit to undergoing surgery.

It is difficult to offer you specific advice without knowing exactly what your definition of what extra large implants would be. There is no universal definition for extra large implants: very large implants may be suitable for some women with the right body type, and completely inappropriate for other candidates. Large implants themselves are not problematic: what is problematic is the use of a breast implant that is too large for a patient's frame.

Your anatomy will determine the limit of the implant size. Factors such as chest width, back width, skin laxity, and existing breast tissue are all concerns that must be taken into account. 800cc implants may suit a patient with a wide chest and ample breast skin, but not be so suitable for a petite patient with very thin skin.

The use of excessively large implants on a patient whose anatomy would not tolerate them carries an increased risk of complications. Some issues that may arise include breast implant displacement , also known as bottoming out or symmastia, breast rippling, tension around the incisions, capsular contracture, and back pain. The longevity of the implants is also likely to be compromised.

While there are some plastic surgeons who will perform extra large breast implant surgery at the patient's request, there are others who will only do so if they are convinced the patient has the right body type to support larger implants. I strongly advise you to find a surgeon with an excellent reputation who can give you honest advice.

Once you have clearly communicated your goals, allow your surgeon to draw on their years of experience to determine the breast implant size and profile that will meet your goals. Most surgeons have implant sizers available so you can get an accurate idea of how different sizes and profiles will look on you.

Dr. Landon Pryor has 2 Breast augmentation before & afters:

Breast augmentation before image performed by Dr. Landon PryorBreast augmentation after image performed by Dr. Landon PryorBreast augmentation before image performed by Dr. Landon PryorBreast augmentation after image performed by Dr. Landon Pryor

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While some women desire more natural results from their breast augmentation, others prefer an oversized look that is more obvious. Plastic surgeons can accommodate a wide range of breast augmentation requests (within reason) but there are issues that must be taken into consideration before a surgeon can place extra large implants.  

In the case of extra large implants, the largest implant currently allowed in the United States is 800cc. The implant limit was determined by safety and health considerations. An optimal breast enlargement balances the chest with the rest of the body and, for most women, an increase of one to two cup sizes is ample to achieve a natural and balanced augmentation.

You should also remember that XL is a relative term. A woman's height and body frame will strongly influence how implants fit the body. Women with broad shoulders and a wide chest can tolerate extra large implants more easily than women with a petite frame. If you are slim and petite, you can achieve a very augmented, high-profile look without needing to use extra large implants.

Saline or silicone implants that are disproportionate with a patient's frame or height are likely to carry a range of  consequences and risks, some of which include:

  • The need to undergo surgery in stages: Your breast skin will probably need to be stretched, using a tissue expander, to create sufficient space for the implants. This approach may also require more financial investment than typical breast implant surgery.
  • Breast sagging: The breasts may begin to droop due to the weight of the implant and the effects of gravity. Over time, you may notice the implants sitting lower on the chest because the skin has stretched. Revision surgery or a breast lift will be necessary to correct this issue.
  • Loss of nipple sensation: Women who opt for larger implants risk losing some feeling in the nipple-areolar complex because of over-extension of the nerves.
  • Difficulties purchasing clothing: Buying bathing suits, underwear, or everyday clothing items will become more challenging as many garments will need to be custom made.
  • Changes in people's behavior: You may also notice the way that people interact with you will change, which can be unsettling.

If you are convinced that XL implants are what you want, I recommend that you find a plastic surgeon who is experienced in extra large breast augmentation procedures. They will be able to examine your body and breasts and give you professional advice about the most effective and safest way to achieve your aesthetic goals.

Dr. Frederic Corbin has 1 Breast augmentation before & after:

Breast augmentation before image performed by Dr. Frederic CorbinBreast augmentation after image performed by Dr. Frederic Corbin

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It’s important to define what you mean by XL. In the US, you can purchase XL implants up to approximately 800cc in size. Extra large silicone breast inserts of 1000cc and higher are available in some other countries but not in the US.

Typically, patients work their way up to larger sizes as most women simply don’t have enough available skin to cover an 800cc insert. By beginning with a smaller size and working up to an XL size, the skin can then adapt to accommodate them.

In order to support extra large sizes, your plastic surgeon may recommend an “internal bra” to help lift the breasts and prevent sagging.

It should be noted that there are numerous problems associated with breast augmentation and with extra large implants. Statistically, they’re less safe than smaller implants.

With larger implants there is a greater risk of capsular contracture, asymmetry and “bottoming out,” which is when the implant drops down too far. Extra large breast inserts are also correlated with a higher incidence of infection.

On a purely aesthetic level, you may also notice that, with XL implants, there are potential issues with areola stretching and sagging of the breast itself.

All plastic surgery carries risks. I’d suggest you inform yourself to the best of your ability of what it is exactly that you want to have done and then find the board-certified plastic surgeon that you feel will do the best job.

Dr. Christine Blaine has 11 Breast Augmentation before & afters:

Breast Augmentation before image performed by Dr. Christine BlaineBreast Augmentation after image performed by Dr. Christine BlaineBreast Augmentation before image performed by Dr. Christine BlaineBreast Augmentation after image performed by Dr. Christine BlaineBreast Augmentation before image performed by Dr. Christine BlaineBreast Augmentation after image performed by Dr. Christine BlaineBreast Augmentation before image performed by Dr. Christine BlaineBreast Augmentation after image performed by Dr. Christine Blaine

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Yes, you can get this surgery in the US, although not all plastic surgeons perform XL breast augmentations. Some clinics in the US will overfill saline inserts up to 2,500cc.  XL sizes are technically defined as any implant size above 600c. The largest size available in the US is 800cc.

For silicone implant sizes above 800cc you would need to seek treatment offshore.

Please note that there are multiple potential risks with larger implants: from back pain to excess pressure placed on the breast tissue. XL breast implants also stretch the skin very tightly potentially causing aesthetic issues like rippling and stretching. Over time, the increased weight and projection of the larger inserts may also cause excessive sagging.

I suggest you contact a board-certified plastic surgeon for a consultation and discuss what the best options are for you.

Dr. Robert N. Young has 1 Breast augmentation before & after:

Breast augmentation before image performed by Dr. Robert N. YoungBreast augmentation after image performed by Dr. Robert N. Young

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What size are you looking for?

Dr. Arthur Shektman has 4 Breast augmentation, Breast lift before & afters:

Breast augmentation, Breast lift before image performed by Dr. Arthur ShektmanBreast augmentation, Breast lift after image performed by Dr. Arthur ShektmanBreast augmentation, Breast lift before image performed by Dr. Arthur ShektmanBreast augmentation, Breast lift after image performed by Dr. Arthur ShektmanBreast augmentation before image performed by Dr. Arthur ShektmanBreast augmentation after image performed by Dr. Arthur ShektmanBreast augmentation before image performed by Dr. Arthur ShektmanBreast augmentation after image performed by Dr. Arthur Shektman

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