How Big Of Breast Implants Can I Get?

Q: Dr. Eppley, how large of breast implants can I get? I know that most women don’t want to look like they have had breast implants but I do. I want a very round and very full look to them. I have a good breast shape 34C with no sagging but they look very small. I don’t know what extreme breast augmentation means but I think that is what I mean. I have had several consultations and I have tried on various sizers. (Mentor sizing system) The plastic surgeons I saw said they would not put in more than 500cc but I like the 650ccs the best. Is this too much for me? if I like the look why won’t they do it?

A: The size of breast implants is, of course, a very personal choice and no one can tell you what you should like. That is up to you. But it is important to remember that it is a medical device and there are risks and potential complications with them. These potential adverse effects can become more apparent or likely when the implant ‘exceeds the tissues to support them.’  Thus size can make a difference in these risks. Exceeding the limits of breast tissue support can be simplistically thought of as violating the breast base diameter, the existing perimeter of your natural breast skin mound. This can be measured in centimeters as well as can the base width of an implant. (as implants get bigger so does it’s base width) If the implant base width stays within your natural breast base width, the implant will be well supported by the tissue attachments and have little risk of bottoming out (dropping) over time. When an implant’s width exceeds that of your natural breast base width, the tissue attachments are stretched and the risk of the implants dropping, going to the side excessively or otherwise losening their retention up on the chest wall will likely occur over time. This can be a difficult problem to fix later.

What your plastic surgeons are telling you, and some plastic surgeons absolutely will not violate this guideline, is that your size request is exceeding what is believed your breast tissues can support. This is likely what they mean by being ‘too big’. I tend not to be so rigid about this concept and will let patients choose the breast implant size they want. But I do advise them, like much of life, the choices we make today will always have future ramifications.

Dr. Barry Eppley

Indianapolis, Indiana