Updated September 2018
A lot of women dreamed of having large breasts after breast implant surgery, and so they went big—really big. What surprised them was the revolving door of complications they'd have down the line. Back and shoulder pain, ouch! Stretched skin and sagging breasts, no thank you!
So that you don't step down the same road blindly, take a look at the potential health implications that come with oversized breast enhancements.
Problems you face with large implants
A lot of women choose to go big because breast augmentation is a considerable investment; they don't want to be part of the crowd of women who wish they had been less conservative. Yet, when they decide to go with breast implants that are too large for their anatomy, they end up being part of another group of women: those with big breasts and big problems.
When you decide to get large or XL breast implants, you sign up for one or more of the following:
- Shoulder and back pain
- Stretched skin
- Torpedo appearance
- Sagging breasts
- Translucent skin and visible veins
- Rippling under the skin
- Thinning breast tissue
- Stretched nipple-areola complex
- Premature aging of the breasts
- Necrosis of the nipple-areola complex
- Lateral implant displacement (the breasts spill out into the armpit)
- Symmastia (breasts so close together they appear as one boob or uniboob)
- Bottoming out (breast implant slides out of the breast pocket, resting or bulging in the inframammary fold)
- Breast implant extrusion (the skin breaks, causing the implant to be visible or exposed outside the body)
Join this group, and you could be looking at least one breast revision surgery within the first few years of having a breast augmentation. Even then, revision surgery is more complicated and may or may not fully resolve your problems, leaving you with some permanent runoff from your previous complications.
What else to consider before choosing oversized breast implants
Aside from physical implications, choosing oversized breast implants can infringe on your lifestyle.
Limited physical ability: Women with extremely large breasts, whether natural or from over-sized implants, find that their breasts impact their ability to perform physical activities. Not only do their breasts get in the way, over time, but weight from the breasts can also cause shoulder, neck, and back pain. Also, the added weight of the larger implants can lead to sagging of the breasts—a result that 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 to 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.
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 fits properly. Shirts and dresses that fit in the chest will often be too large around the shoulders and waist.
Big implants: how big is too big?
Breast implant sizing isn't so cut and dry—there is indeed a gray area. A woman who is petite may find that 450cc breast implants are too big for her frame, while a woman who is much taller and larger may be suited for 600cc's or more.
What it will come down to is your:
- Breast width diameter (BWD)
- Skin laxity
- Breast tissue density
Once your surgeon evaluates your breast tissue and skin and calculates your BWD, she will discuss which implant sizes work for your BWD and breast type. She will give a range, taking you from your minimum to your maximum. So now, we can answer the question of how big is too big. It's when you go past the maximum implant allowed given your anatomy.
How to prevent getting breast implants that are too large
To avoid going too big, be open and honest with your surgeon about the size goals you are trying to achieve but ultimately let her guide you to the implant size that is best suited for your anatomy. If you did your research and believed she is as good as others say, then allow her to do her job.
As for your part, during your consultation make sure to do the following:
- Take goal photos to your appointment
- Clearly state your size goals
- Try on breast implant sizers
- Take 3D breast simulators for a spin
All of these things put together should help you and your surgeon find the perfect breast implant size for you.
Getting the best breast implant size and fit
The American Society of Plastic Surgeons has weighed in on the matter, stating that for a breast augmentation to provide a balance between the chest and the rest of the body, the following should be considered:
- Shoulder width
- Breast height
- Breast width
- Ribcage width
- Body contour
As a general rule, however, breast implant size should be no more than two cups above your natural breast size and the breast implants should be slightly narrower, if not the same width, as the width of your breasts.
An implant that is too narrow will leave you without cleavage and upper pole fullness, giving you a ball-in-a-sock look; one that is too wide will push the boundaries of your natural breasts, causing your augmentation to look, well, augmented. Not to mention you'll have to cope with some potential complications.
It's vital that you and your surgeon find your sweet spot, and you can only find that during a breast augmentation consultation.
Wondering whether the breast implants you want are too big?
Our board-certified plastic surgeons field a lot of questions from women who want to know if the breast implant size they've chosen will be big enough for them. Frequently it comes down to the wire, with women mulling over a size difference no bigger than a shot glass—just days before they go under the knife.
Don't wait until it's crunch time. If you have specific breast implant sizes in mind and want to know if they are right for you, ask our surgeons what they think about size, and then discuss the topic with yours. Provide details. Let them know your height, weight, breast width diameter (if you know it), the implant sizes you are considering, and any other useful information.