Breast Implants: How to Know When You're Going Too Big


A recent phenomenon that I have noticed is that women are choosing larger and larger breast implants when having breast augmentation. This is something that has gradually increased over the years that I have been doing breast surgery. And I am left with two questions: is there an upper limit in sight? And, how big is too big?

About twenty years ago, the volume of implants that were usually chosen was less than 300 cc. And it was quite rare to go much above that or even into the 400’s. Today, I rarely use an implant less than 300 cc, and it is common to use implants in the 400’s. Additionally I am not infrequently using implants which are 500 cc or even slightly more. So what is driving the escalation in breast implant size and how much is too big?

Why women are choosing larger breast implants
I do not think there is any one single thing that is causing women to want to use larger breast implants. Frequently they tell me that they have been advised by their friends who have had breast enlargement to go a little bigger in size so that they will not be disappointed. Many women tell me that they feel after having had the surgery that they would go bigger if they were to do it over – even though some of these women are now wearing a D cup after surgery.

Now let me point out that these women are not kooks or unreasonable people. But there can be a change in desired breast size after surgery. Some women who, prior to surgery are concerned about going too big, find that once they have the surgery they get quite comfortable with their new size and would like to go bigger. So expectations and desires can change and some women may go larger initially in anticipation of this.

Clearly fashions and what many people feel is an attractive style and shape is influencing this. It is more common to find models who are larger in the chest. Particularly swimsuit models. It just seems that bigger breasts are “in.” Therefore, women want larger implants.
But probably the most important factor is that women have much more say in the size of breast implants chosen that they did previously. Going back to 20 years ago I would talk with a woman about her desires and then choose the implant size for her. Now every woman who comes in works with sizers. They put on a bra with different sized implants, put on a tee shirt and look at themselves in the mirror. I will advise on size, but the patient is the one who is calling the shots – for the most part. So the increasing size of implants over the years reflects women getting what they want. And this is great as long as we don’t go unreasonably large.

So how big is too big?
I heard a prominent plastic surgeon say that he would never use implants over 350 cc. To me this is arbitrary and ridiculous. It could be too large for a very petite woman, and not nearly large enough for a very tall woman with a broad chest.
Keep in mind that there is no perfect size. I frequently tell patients that if everyone was between a very full B and Moderate D cup, I would be out on the street corner with a sign that says, “Will Operate for Food.”

What women will find if they have overdone it with implant size is that their breasts can get in the way of physical activities, can cause shoulder and neck pain, and it may be hard to find clothes that fit. Also, greater weight in the breast can lead to sagging of the breast due to the weight of the implants.

But there is another, more aesthetic concern, at least for me. A full breast is very attractive. This probably represents a full C or D cup. Going larger than this in many women will not look as attractive because their body is now out of proportion with the breasts not fitting the body. And sometimes, these larger implants make a women look boarder in the chest, not necessarily larger in the breast. This can actually make a women look heavier, not exactly to look most patients are trying to achieve!

So, again, how do you know if you are going too big? I think this depends upon your body size and type, what your physical activities are, and perhaps your profession. But perhaps the key here is how to maintain good proportions to your body. And for this I cannot give specific sizes.

Use these guidelines when deciding on your breast implants
If you are short, or have a narrower chest you will be better off in the lower range of implant sizes. If you are tall or have a very broad chest, larger implants may look better. In this regard, it is rare to need implants larger than 450 t0 500 cc in most women. But in someone who is 6 feet tall (and, yes, I have patients like this), 500cc may look somewhat modest.

If you are someone who is very active in sports, especially higher impact sports like running, or kick boxing, you will want to not go over the top in size or your breasts may now get in the way. While there are some great sports bras that can help, it is very hard to find marathoners who wear a double D bra. So as you try on the sizers, don’t just think about how you will look in a bathing suit or halter top, but think about you physical activities as well as the kind of clothes that you will wear every day.

My goal in all of this is to give women what they want, not just today but over the course of their lifetime. If that means a modest increase in breast size, great. If it means going very large, that can be good too. But I want to try to avoid creating a disproportionate figure, or creating a problem later in life where the weight of the implants and the size of the chest are too much. And the other issue is that I want to make the breasts really look good. This can be difficult if the implants are either too big or too small for size and shape of both the natural breasts and the chest itself.

Yes, you can go too big
Bottom line here is that you can go too big. But there is no specific number of cc’s for everyone. Everyone is different and everyone wants something different. We will do our best to guide you to something that looks great both today and tomorrow, and something that will fit your body and your lifestyle.

All the best,
David B.

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Knoxville Plastic Surgeon