Breast Implants: How Big is Too Big?

by Dr. Cameron Craven

Alongside general breast augmentation procedure questions, one of the most common questions women ask is “How large should I go?” This question leads to a conversation about breast implant size options, where oftentimes it's determined that the patient is looking for something that is just too large for her body frame.

Choosing a breast implant size is a critical decision that can be the difference between loving your surgical results and having second thoughts after your procedure.

Why Oversized Breast Implants Are Not Right for Any Woman

Physical implications: Women with extremely large breasts, whether natural or from over-sized implants, find that their breasts impact their ability to perform physical activities. Over time, weight from the breasts can cause shoulder, neck, and back pain. In addition, the added weight of the larger implants can lead to sagging of the breasts - a result which counters the purpose of the augmentation.

Aesthetic appeal: A full breast, which I define as a full C- or D-cup, is considered very attractive. However, depending on the woman’s body frame, bigger is not necessarily always better. Breasts that are out of proportion with body size and frame may look awkward. They may make a woman appear broader in the chest rather than more voluptuous, giving an overall larger, heavier appearance. Most women are not pleased with this result.

Complications: Larger implants are associated with an increased risk of complications. The skin envelope will be stretched thinner with a larger implant, thus putting the patient at a higher risk of developing hard-to-correct or potentially irreversible changes. Infection risks are greater in these cases as well, as are the chances of your implants “bottoming out,” a condition where breast implants dropped lower on the chest, making the nipple too high on the breast mound.

Wardrobe issues: 84% of women cite looking better in their clothes as the reason for undergoing breast augmentation surgery. However women who choose overly large implants may find it difficult to find clothing that fit properly. Shirts and dresses that fit in the chest will often be too large around the shoulders and waist.

Selecting Implant Size: Why Body Frame and Proportion Are Important

A key measurement to have when beginning your search for the best breast implant size is knowing your base width.

Natural body size: If patients focus on a proportioned size for their body, they are going to be much happier with their result. Proportion is the key to aesthetic balance and appeal. Petite women and women with narrower frames are more likely to have their natural sizes fall within the lower range. Taller and wider women will need larger implants to fill out their shape (450 cc or more).

Try before you buy: One of the biggest “must do’s” when considering size is to try on implants before the surgery. Consider their effect on your style by trying them in a bathing suit, a regular dress, and anything else you wear (or plan to wear) regularly. And finally, ask trusted family or friends for their perspective, as third party perspectives are very important.

Clarify your expectations: This step is important both for you and your surgeon. After you have completed the above two steps, establish a final goal for your new shape. Are you aiming to look natural, or are you comfortable appearing surgically enhanced? Be sure to think about the long term while considering this decision.

Once you have clear goals in mind for your final outcome, communicate your expectations to your surgeon. In this case a photograph is worth 1,000 words. It’s best to look at before and after photos of prior patients who have a similar body shape to you.

Trust Your Plastic Surgeon

Ultimately, if you have carefully considered your body shape as well as the lifestyle and aesthetic impact of implants over time and you have effectively communicated those goals to your surgeon, the onus is on him or her to deliver. Trust your surgeon to help you select the appropriate implant size for you. Oftentimes during the consultation or pre-op appointment, your surgeon will have a full range of breast implant sizers to try out on your body. This will help the surgeon and you make the final decision on what breast implant size is best for you, while keeping in mind the expectations you have clearly discussed with him during consultations.

About The Author

Dr. Cameron Craven is a board-certified plastic surgeon currently practicing at Austin-based Westlake Dermatology & Cosmetic Surgery. Dr. Craven serves as an investigator for the Mentor Post-Approval Study for Silicone Gel Breast Implants.

Updated September 2016

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