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Today’s famous faces include some ladies who are somewhat blessed in the chest department! The desire to be as beautifully curvy as some of these media favourites often tempts females of all ages to decide that they would like to have extra large implants.

We wish to point out that although there is no harm in wanting to have these extra large breast implants, anyone making this decision should be aware of all the necessary information, increased risks and possible complications that may occur when extra large implants are used for augmentation.

Apart from understanding whether or not you are a suitable candidate for the extra large implants, you must also take into account not only the procedure, but also the recovery time involved.

Possible complications and adverse outcomes that occur in at least 1% of breast implant patients at any time, for which you may need non-surgical treatments or additional surgical treatments to treat any of these, are shown below.

  • Asymmetry – the breasts can be uneven in their appearance in terms of shape, size or breast level on the chest wall
  • Breast pain may occur, both in the breast and/or nipple
  • Breast tissue atrophy may occur resulting in a shrinking/thinning of the supporting skin
  • Calcium deposits may occur resulting in hard lumps forming under the skin around the implant. These may be mistaken for cancer, which may result in extra surgery
  • Capsular contraction may occur, which is a tightening of the tissue capsule around the implant. This can result in hardening and squeezing of the implants in severe cases
  • The patient may experience delayed healing, if the incision site fails to heal normally. This means recovery will take longer
  • Displacement/Malposition may be caused if the implant is not in the correct position in the breast. This can happen during surgery or afterwards if the implant should move or shift away from its original location. This shifting may be caused by several factors, including as gravity, trauma or capsular contracture
  • Extrusion may occur, meaning the skin breaks down and the implant may appear or be felt through the skin
  • Infection may occur if wounds become contaminated. This usually appears within a few days to a week after surgery. This would be treated with antibiotics and if there was no response then the implant might need to be removed
  • Inflammation/irritation caused as a response by the body to infection or injury, usually seen manifesting as redness, swelling, warmth, pain and/or loss of function
  • Necrosis may occur, which is dead skin or tissue around the breast. This can be caused by a number of factors, including the use of steroids in the surgical breast pocket, smoking, chemotherapy/radiation and excessive heat or cold therapy
  • The large implants require large dissection underneath the muscle (or worse under the breast). This creates a large “pocket”
  • Droopiness occurs much more quickly, which would require a breast lift in the future
  • Revisional breast surgery in patients who have had very large implants in the past is at risk for complications, even for the best surgeon. The internal pocket is simply huge, and the existing techniques for reducing the size of those capsules are weak. If a pocket is made that is large, the muscle is often removed from the chest bone (sternum) and ‘jumps’ when it is used. This problem is not usually fixable
  • The implants can erode into the ribs, causing a change in their shape
  • A ‘double-bubble’ problem can occur, where the implant and the silhouette of the old breast are simultaneously visible
  • Large implants can have the unintended consequence of making patients look ‘matronly’
  • Stretch marks are common and untreatable
  • The chance of revisional surgery is much higher. The results of that revision surgery are far worse than for normal size implants
  • Nipple/Breast sensation changes may be felt in varying degrees and this may be temporary or permanent
  • Early sagging of the breast may occur that is normally seen as a result of ageing/pregnancy/weight loss
  • Any collection of fluid around the implant may result in swelling, pain and bruising. The body may absorb small seromas, however with larger ones surgical drains may be required
  • Any wrinkling of the implant will be more obviously seen or felt through the skin

Any type of surgical operation carries a risk. By reducing the number of risks there is a higher possibility that the operation will be successful and the patient will be happy with the results. Although there are many successful breast augmentations performed with large implants, we want anyone choosing these implants to be fully aware of the many possible outcomesbefore they make a decision as to how large they would really like to become.