Is There a Limit on How Big of a Breast Implant Can I Go Before It Compromises Skin Elasticity?

The answer to this is fairly straightforward. The largest implant that will fit, look right, and your tissues will accommodate is one that matches the width of your breast and is a high profile in forward projection. Unless your breast is unusually wide or narrow for your chest around, this would correspond to a 2 cup size increase from what you started with. We know this works from experience. If you attempt to put in an implant larger than that, you are risking distortions of the skin or tissues and malposition of the implant. Skin and tissues are very accommodating. We know this from experience with tissue expansion using expander devices, but you have to give the tissues a chance to accommodate and not try to push too far too fast. If you wanted to increase larger than two cup sizes, the way to do it is do the procedure properly the first time with a properly fitted high profile implant and allow the tissues to adjust over a few months. Then you can go back and exchange those implants for larger ones (usually increasing another 1/2 or so in cup size) and the tissues will adjust without problems. You could keep doing this over time up to the limit of the volume of implants available -- currently about 800 cc's. 

Dear Amy3,

You have touched on an important point with regards to large breast implants. As skin is stretched, there is a physical limit to how much it will stretch before damage occurs. This damage is most commonly seen as striae (stretch marks). Stretch marks occur because of tearing of the dermis (a layer of you skin) from excessive stretching. Pregnancy or rapid growth spurts can cause stretch marks, and so can breast implants. Once stretch marks have occurred, it is a sign that the skin is permanently damaged, and has lost some of its elasticity. There is no way to repair stretch marks or stretched skin, so use caution when going from a AA size to something much larger. Although there is no way to tell how large of an implant your skin can tolerate, to be safe, you should consider staying with a conservative implant size if you are concerned about affecting your skin's elasticity.

Best Regards

Sizing breast implants is so tough. If an implant is too big them it causes permantvthinning of the breast tissue. The implant thus becomes more easy to see and feel. I am rigidly flexible and very conservative. I measure the width of the breast and stickbto it. If a patient wants to go bigger then I will go up one profile ( to midrange ). I think that high profile implants put too much pressure on the breast. It's all about the long term health of the breast.

Yes, increases in  size can lead to the  development of negative consequence on overlying tissues. Your plastic surgeon can best advise you on what would be appropriate for your frame. It depends on many individual characteristics besides just starting cup size. Larger implants exert more pressure on surrounding skin and tissues, and cause thinning, stretch, sagging, and rippling. Over time these effects can be uncorrectable. Therefore, think about long term effects, not just cup size, and follow the advice of your doctor. 

There is no formula for predicting skin elasticity and it is remarkable how much volume the skin can accomodate. A AA cup in a 5 foot individual would likely handle a smaller implant than a 6 foot female. In general, implants are "fitted:" according to the base diameter and predicted skin elasticity. This can be crudely measured or estimated.

The implant needs to "fit" your breast. Choosing an implant that is narrower than the breast allows for better concealment. The elasticity of the skin is a very important component of implant selection. The reality is that if you are starting with AA breasts and a tight skin envelope, then large implants may simply not be an option. Overstretching can lead to vascular compromise and possible skin loss at the extreme. More commonly, an unattractive augmentation is the result of placing implants that are too large for the breast to accommodate.

Great question Amy3...but tough to answer. Patients come in all the time and tell me their cup size,"I wear a Vic's Sec B but a Target A... and I want to be a C cup after surgery.". Because bra manufacturers do not use a uniform "cup" size to make their bras, the cup sizes and therefore the fit of bras are different.

So I have been taking the time in the initial consultation to measure each patient's "cup" size in my office. This gives me the starting point. If I measure an A cup and the patient desires a 2 cup increase (A to C) I can judge the volume needed to achieve the goal...however, other factors, like skin elasticity and quality, breast tissue volume and quality as well as width of the chest wall are many of the ingredients I use to make sure the implant of a desired volume will fit. 

I have also been using 3D imaging recently to further evaluate what looks best and which implant style fits best and achieves the desired goals.

Best advice is to locate a board certified plastic surgeon with great experience in breast augmentation (or as many as you are comfortable seeing) and have them evaluate your anatomy and determine the best sized implant for your body....because, YES, an implant that is too BIG for your anatomy WILL cause problems down the road and may lead to further surgery.

Good luck!

Dr. C

UPDATE :

Extreme plastic surgery, especially surgical misadventures in other countries, has devastating consequences. Be smart and listen to what your Board Certified Plastic Surgeon recommends.

"On September 15, 2010, Sheyla Hershey had her breast implants and most of her own breast tissue removed due to Staph infection. According to her latest blog on her ofiicial website, she still has not lost her official "title" as the woman with "The World's Biggest Enchanced Breasts", and hopes to be able to have perhaps have her breasts re-enlarged within the next "few months"."

Hard to determine what size implant your skin envelope will accommodate.  The real key for your is the degree of soft tissue coverage over the implant.  With AA size breasts it is unlikely that very large implants will be possible These large implants will give you an abnormal shape.  A plastic surgery consultation will be helpful when making this type of decision.   

hi there-

You are correct in thinking that your skin will be the major limitation in the size of the implant that would be recommended for you.

This is something that could only be reasonably estimated by your surgeon during an in-person physical examination. Good luck!

You have given too little information to make a reasonable guess on what your needs are. Pictures help a lot and measurements , current skin elasticity and your history of pregnancies and breast feeding. 

An examination with a Board Certified Plastic Surgeon would answer most of your concerns .