When women choose to have breast augmentation, implant size is one of the most personal decisions in the process — and for some patients, that decision lands well above the standard size range. Extra large breast augmentation refers to implant volumes beyond the typical maximum offered in the United States (800cc), reaching 1,500cc, 2,000cc, or in select cases significantly more. Achieving these volumes is not a single-stage procedure. It is a carefully planned multi-surgery process that combines staged tissue expansion, specialized implant selection, and reinforced internal support — and it requires a plastic surgeon with the specific experience to execute each phase safely and aesthetically.

Dr. John Anastasatos performs extra large breast augmentation at his Beverly Hills practice with the international surgical experience and specialty credentials this complex multi-stage procedure requires. With dual practices in Beverly Hills and Athens, Greece, Dr. Anastasatos has direct working experience with the broader range of silicone implant volumes available in Europe (up to 1,200cc) — a perspective most U.S.-only plastic surgeons do not have. He has delivered plenary lectures at the Pan-Hellenic Congress of Plastic Surgery on endoscopic breast surgery at the highest academic level, and brings over 20 years of cosmetic breast surgery experience to the planning, staging, and execution of extra large augmentation cases. Board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

What Does Extra-Large Breast Augmentation Mean?

Presently, the largest breast implant volume available in the United States is 800cc, for both silicone gel-filled and saline implants. However, with the rising trend of having fuller curves, some patients also desire to have a breast volume larger than 800cc. Thus these patients choose to have Extra-Large Breast Augmentation surgery. They may choose largest saline implants available, and through gradual process inflate them to the desired size of 1,500cc or even 2,000cc. There are cases where implant volume can go as big 5,000cc. In Europe silicone gel filed implants exist up to volumes of 1200cc.

Breast Revision

What Does This Surgery Entail?

Extra-Large Breast Augmentation is a multi-stage process. First step involves getting an initial breast augmentation. Then after several months, once the breast tissue stretches from getting accustomed to having implants, a patient undergoes another breast augmentation to switch to bigger implants. With each surgery, a patient gets closer to the desired size by overfilling implants and stretching breast tissue. It may take 2-3 surgeries, depending on how big a patient would like to be.

What Type of Implants Are Used in XL Breast Augmentation?

Saline implants are used exclusively for this surgery because they can be overfilled, and for their stretchy durability.

As you can imagine, these implants may be quite heavy on the breast tissue. In order to prevent thinning of the skin, rippling, and sagginess, a surgeon may use an internal-bra method to help with long-term support of such implants. An internal-bra may either implement a suturing method or an FDA approved tissue or mesh that is available in the market.