Would Like 700cc Implants, Why are Some Doctors Against That Size? (photo)

There is nothing at all "wrong" with larger implants, if you have the desire for that size and anatomic capacity to allow them. I have done breast augmentation for over 25 years, and do well over 100 cases of this specific operation each year, as does my partner. We have no specific reservation about large(r) implants in the appropriate patient who wishes them, and these patients do not have an increased incidence of "bottoming out," capsular contracture, or other complications compared to women who choose smaller implants.

Of course, smaller implant placement is a tiny bit easier and requires a correspondingly smaller pocket to be created surgically, but these are truly trivial in the entire scope of this operation. We charge the exact same price for implants of ANY size, and the same exact price for the operation, so this should give an indication of the scant difference between one size vs. another.

Perhaps some surgeons who are "against" larger implants are simply trying to seek a less "done" or "over-the-top" look. Some surgeons may "fear" larger implants because they may 'bottom out" more than smaller, lighter implants, although I believe this is related to (too low) placement and failing to take into account the effects of gravity. I believe that even large(r) implants, if placed skillfully and with minimal surgical trauma to the tissues, can yield soft and "amazing" results. Other "cosmetic surgeons" may not be fully-trained plastic surgeons board-certified by the American Board of Plastic Surgery--be sure to check credentials! But you have done that, and have the additional input of 4 friends who have seen your surgeon with good results. Trust your own impressions, those of your friends, and place less emphasis on an on-line answer from a surgeon who has not had the ability to examine you and talk to you in detail--including me!

Please also realize that breasts come in all sizes naturally--we do breast reductions as well as augmentations. So "large" is not at all "unnatural," it's just large! What you want is soft and properly-positioned implants. Sounds as if you have found the right surgeon! Best wishes! Dr. Tholen

The size of the breast implant is usually decided based on measurements of your breasts, your tissue elasticity and chest wall shape. As the implants get bigger they also get wider. When the tissues are less elastic certain distances don't change. For example the distance between the midline over your sternum and the nipple. A lager implant has to gain room more on the sides of your chest and the nipples would not be centered on the breast. This is how the dimensions of your chest, breast and the quality of your tissue dictate size. In general the larger you are, the larger breast implant you can tolerate. If you try to bend these rules you may get away with it occasionally but the incidence of complications becomes higher. I hope this exploitation is clear to you and will help you understand the principles behind the reluctance of most plastic surgeons recommending larger implants.

Breast Implant size is a combination of personal preference and your body size/shape.  Even if you prefer a very large implant (greater than 650cc) this may not always be a good choice for you.  The large implant must "fit" your body, meaning that it cannot be too wide for you which will result in "uni-boob" or "side-bood", 2 bad complications.  Also, large implants exert pressure on the inside of your breast. Over time this can cause atrophy, or thinning, of yoru breast tissue and also may cause your ribcage to indent and become concave.  These long term complications are not reversible.  Also, large implants are heavy and can droop, sag, and "bottom-out" over time.  Plastic surgeons are not opposed to placing these large implants in appropriate situations. You need to have a very detailed discussion with your board certified plastic surgeon to see if the choice for large implants is best for you.

I have no objection to larger implants in suitable patients.  This is a decision that needs to be based on multiple variables.  That said, long term studies show more problems with larger implants over the years then smaller implants.  So just a cautionary of "buyer beware" for really large implants.  All the best !  Dr. Joe

This is a very good question.  When choosing your breast implant size there are certain factors that should influence the surgeon and patient.  What is the patients breast diameter?  How much natural breast tissue is available to cover the implant? Does the patient want to look obviously augmented?  Does the patient mind that the large breast size may make her look overweight?  These are important questions because in a smaller patient the larger implant sizes can thin the natural tissue and make the implant more visible through the skin. Also try "wearing" the sizer implants for a day to see if the weight on your shoulders is comfortable.  The goal of any plastic surgeon is to make sure you are well educated heading into your decision for breast augmentation, this prevents any regrets or surprises.