Is it more risky to have larger breast implants?

I want to ask you guys a question about breast implants? Let’s say a women has B + cup size, but she wants to go all the way up to a D cup? Can there be any risks that the larger you go there might be some types of complications after the surgery? Also, I saw videos from surgeons on TV where they make smaller cuts under the arm pit to insert the implant where in the past they used to make a round cut around the breast? After the surgery do they use stitches after inserting the implant?

Doctor Answers 18

Is it more risky to have larger breast implants?

Size and shape of breasts can often play a critical role in a woman’s self-esteem. Fuller and bigger breasts are often associated with reproducibility therefore it is a desired condition. There are different kinds of breast augmentation operation types. Breast augmentation can be performed either with breast implants or autologous fat transfer. There are also different types of breast implants like teardrop or round implants. These implants also can be placed under or above the muscle. As you can imagine there are several different options for breast augmentation. The best way to understand which one is more suitable for you is to get a physical examination by a plastic surgeon.

Turkey Plastic Surgeon
4.9 out of 5 stars 90 reviews

Risky to have larger breast implants

If one has a frame that can accommodate larger implants, there are no significant risks to going an implant that may give one a 2 cup increase. If one is pushing the volume significantly, there is a higher chance of being able to feel the implant as there is less skin and breast tissue to cover the implant. Obviously, a larger implant weighs more than a small implant and over the years, especially if one has stretch marks, may be subject to gravity more. One must balance this off with the advantages of larger implants.

George Volpe, MD
Newton Plastic Surgeon
4.8 out of 5 stars 26 reviews

Larger implants bring more risks with them

but life is about living and having what you really want so if you want the biggest possible, realize that you will achieve that but with time, gravity and stretching will impact your breasts and you will eventually require a lift and downsize of what you have.  Some surgeons will refuse to do over a certain size but you can easily find someone that will and who shares my philosophy on life.  Larger implants do not increase risks in my opinion except for a great risk of nipple numbness as the pocket size could damage the nerves.  The armpit approach has the greatest risk for contractures and I try to do everything possible to minimize that risk - I do not use the armpit at all.  All surgeons use sutures to close the wound but some like dissolvable and others permanent.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Is it riskier to have larger breast implants

The answer to your question can be either yes or no.  If you stay in the perimeters of your breast dimensions the answer is NO.  In fact, frequently in my practice women come to me who have had implants placed by another doctor to have them replaced for larger ones.  However, going larger than your body can handle can lead to bottoming out or high riding implants and other issues.

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 39 reviews

Risk with larger breast implants

Thanks for your question.  Implants that are disproportionately large for your body frame can be associated with increased risk of problems like visible ripples, sagging, and other issues.  Implants can be inserted using an incision in the arm pit, under the breast, or around the areola.  Every incision has advantages and disadvantages that can be explained in detail during a consultation.  The incision is usually stitched with dissolving sutures.

William Andrade, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 66 reviews

Is it more risky to have larger breast implants?

Large implants are associated with a higher risk of complications, including malposition, capsular contracture, stretch marks, rippling, and ptosis. Implants can be inserted through a variety of incisions. All incisions are closed with sutures at the end of the surgery. Your plastic surgeon should go over all of these details when you have your consultation. Thanks for sharing your question. Best wishes.

Dr. Gregory Park

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Breast Augmentation: Options

Dear Ms. Jessica.alba,

Thank you for your story and questions. Unfortunately without nude photos and a actual
exam I am limited (including taking accurate measurements of your chest) And can only give you non specific but hopefully helpful comments.

Choosing the correct breast implant is a multifactoral depending on your anatomy, skin strech, desired look and size.

Breast size is a very personal choice and using a variety of techniques (some of which you may have completed) you can achieve the size and look you desire.

Unfortunately bra manufactures have not standardized cup sizes.
Breast implant manufactures have created a wide spectrum of implants based on a "cc" measuring system. Different base widths result in different projections for the same size of cc's. Different shapes are based on the cohesiveness of the internal gel.

My responses are:
A)purchase several bras (full bodied and no padding) of the size you think you want to
be. As you realize there are no standard bra (strap/cup) sizes.
B)take a measuring cup (1 oz=30cc) place rice in a nylon
C) try on various volumes of rice with some form fitting clothes.

2)placement of implant:
Select several nude model photos of the goal breast shape you desire.
Placement decision of implant(subpectoral, dual plane, or suprapectoral) will be determined based on your anatomy If the implant is placed under the pectoralis muscle I usually add 10% volume to what the patient chooses.... to compensate for the muscle pressing down on the muscle and for the naturally settleing of the implant which often makes the breast appear smaller 2-3 months after surgery.

3)profile of implant:
A) for the same volume the higher the profile the narrower the base width.
B)there is very little difference in projection between a moderate to high profile implant
thus little affect on the perceptible final projection of your breasts.
C) the base width of the breast should equal the base width of the implant
D)thus I personally chose the profile based on the patients chest measurements,
(a high profile on a wide chest may not result in the cleavage desired and
conversely a low profile on a narrow chest may result in implant in the outside arm

4)types of implants:
A) round
B) anatomical or shaped be (form stable)

5)Filler material
A) Silicone gel
B) Normal Saline

6)there are four companies that produce breast implants:
-1) Mentor
-2) Allergan
-3) Sientra
-4) Ideal
1-2 =silicone fill comes from same factory
3 =silicone gel has highest cohesiveness (gummy bear) for round implants
1= only implants made in USA
1-2 = make both silicone and normal saline filled implants
4= only makes normal saline filled implants
4 = has internal baffles in normal saline implant to give feel more like silicone filled implants
1-4 = all FDA approved, lifetime warranties
3-at present voluntarily suspended distribution
1-3 have capsular contracture warranty
1-3 have different profiles (for same volume different base widths) resulting in different projections.
1-3 have anatomical or shaped implants.

I personally use all four companies based on the above and the best "fit" for the patient.

7)Incision sites:
A) axillary incision (armpit)
B) sub areolar (around the nipple)
C) inframammarry (breast crease)
D) umbilicus (around tummy button)
Each of the access sites have their pros and cons. I personally close all incisions with absorbable sutures.

I suggest you make appointments with several Plastic Surgeon who are experienced and Certified by the American Board of Plastic Surgery and ideally a members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Robert A. Hardesty, MD, FACS
Riverside Plastic Surgeon
4.8 out of 5 stars 99 reviews

Risk with larger implants

Thank you for your question. As long as the diameter of the implant matches the patient breast diameter and the volume and the volume is not to excessive for the breast skin envelope there should not be any problems. I hope you find this useful.  

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 63 reviews

Complications and Large Implants


Complications like rippling, capsular contracture, excessive tissue stretch and malposition, and double bubble are the kind of complications that occur more frequently with inappropriately sized implants. A physical exam from a surgeon who's not afraid to tell you that a D cup is not recommended (depending on your examination, this might not actually be the case for you) will give you an idea of the ideal implant size.

Incisions made under the breast lead to the least risk of problems, follow by armpit incisions. Periareolar incisions are the most popular here in Southern California, but actually put you at highest risk for capsular contracture and other problems associated with scaring of the mammary gland. 

Visit a few surgeons that are certified by the ABPS and are also members of the ASAPS who do a lot of cosmetic breast surgery.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews


Thank you for the question and though an examination is needed, at your consultation your surgeon should go over the relative risks of the procedure for the volume you have chosen and the incisions that can be used to place your implants.  Certainly the axillary approach which you referred to is one that is used and yes sutures are used though they are usually buried under the skin.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.