While not every woman seeking to get breast implants will want them extra-large, some do. Right now in the U.S., the largest silicone gel implant is 800cc—those who want to go bigger must opt for saline and they go upwards of 1500cc or more. 

To accommodate the size of the implants, the skin must be stretched and the tissue manipulated. This can cause the implants to be visible through the skin. To minimize this, fat transfer may be an option. Here, fat is taken from areas that have more fat content, such as the hips and thighs, and is injected into areas around the breasts that need more plumping. 

As mentioned, extra-large implants require the skin and muscles of the breasts to be stretched. Over time, the skin may thin out further, causing the implants to become more visible; or, they may sag from the weight. And should they be removed and not replaced or downsized, reconstruction surgery will be needed to address the issue of sagging and compromised muscle/tissue. One such procedure is a mastopexy, or what is known as a breast lift. It helps tighten loose skin, while internal breast work puts breast tissue back in its rightful place: central to the breast. This then gives the breasts fullness. 

Other issues to consider are: 

Physical limitations: Large breast can affect your ability to perform certain physical activities and over time, the weight from the breasts can cause pain in the shoulders, neck and back. 

Wardrobe issues: Finding clothing that fits can be extremely difficult. Often patients who get extra-large breast implants must get their clothes customized or tailored, or they wear clothes that are not sized properly. 

Aesthetic appeal: Extremely large breasts do not look natural and because of their width and projection, they often make a woman’s body size and frame look out of proportion, with the upper part of the body appearing broader. 

Complications: The skin envelope will be stretched thinner, which could put you at risk of not being able to correct the problem later. Infection is another risk, as is bottoming out, a condition where the implants drop lower on the chest and the nipple sits too high on the breast mound. 

Depending on your natural measurements and the number of cubic centimeter you plan to get to, it may be recommended that your augmentation be staged. This is especially true for patients who naturally have a small bust, for inserting an extra-large implant upon the first augmentation could stretch the skin too fast and cause irreversible damage, as well as unattractive stretch marks. It could also lead to bottoming out. Staging allows the pockets to expand over time so that they can accommodate the larger implant. 

The wait time between stages depends, but could be as long as six months. This is done to ensure the wound and internal structures have healed and that swelling is no longer present.