XL Breast Implants


Extra Large (XL) breast implants help patients achieve a particular look and feel from breast augmentation surgery. The type of implant used will be determined by how large the patient desires to go, taking into consideration the health of the patient’s skin, the size of the chest cavity, and the overall lifestyle of the patient. It is important that patients who receive XL breast implants are still able to have a normal, active lifestyle. The added weight of the implant will play a role in the decision-making process. Generally, to achieve a larger, fuller look, a patient may have to undergo multiple procedures. Every patient’s body has limitations that should be considered before placing XL implants and in the process of deciding how large of implants can be placed.

There are two options when trying to achieve an XL look, using larger silicone gel breast implants or using saline implants and overfilling them to a larger size. What can be accomplished will depend on each patient's specific body type and safety concerns (avoidance of complications).

Options For Breast Augmentation

XL Silicone Gel Breast Implants

The FDA has approved a maximum size of a silicone breast implant at 800 cc (these implants are prefilled). XL silicone breast implants require a larger incision in comparison to saline breast implants.  Silicone Gel breast implants may give a more natural feel to enhanced breasts, as the silicone gel mimics what a natural breast would feel like.

XL Saline Overfilled Breast Implants

The largest saline breast implant shell is also 800 cc, but saline breast implants can be overfilled to much larger sizes. Overfilled saline breast implants may be good options for those wanting significant upper fullness or an enhanced cleavage area. Overfilling a breast implant will make it firmer and can reduce the chance of noticeable skin rippling or wrinkling.


Generally speaking, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery. In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant (other than what is safely "allowed" by the patient's anatomy) can be problematic. Some potential risks can include shoulder, neck, and back pain, bra strap bruising, increased risk of breast ptosis (breast sagging) as the patient ages, and a somewhat higher risk of rupture versus smaller implants. Excessive firmness of the breasts can occur due to overfilled implants and/or internal scaring.

Is Additional Surgery Necessary?

Breast augmentation results are not permanent. As patients age, their skin will naturally become less elastic, and breast ptosis (sagging), drooping, or bottoming out may occur. Maintaining a stable, healthy weight can help retain a patient’s result.

Some patients may also choose to downsize their breast implants and will need revisionary surgery to help with the effects of the breast skin stretching.  Other patients may need to undergo revision surgery to further enlarge their breasts, or due to anatomic restrictions needed a multiple step process to achieve their size goals.

Revisionary breast procedures can include an excision of extra skin and/ or inverted T/ anchor mastopexy, to lift the areola and nipple.

Capsulorrhaphy, internal sutures to tighten the breast pocket, may also be needed when a patient is downsizing, or when a patient needs additional support for XL implants. Acellular Dermal Matrix, also called Strattice or ADM, may be used to support the new weight that has been added due to the use of XL implants.

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