What is Too Big Of An Implant Size For My Breast Augmentation?
Q: Dr. Eppley, I have been researching doctors for breast augmentation this fall. I am interested in breast augmentation and was wondering what your philosophy is about going big enough but not too big for your body. I am an A cup and would like to be a D cup. Another doctor told me a DD would put my body at significant risk for re-operation. My biggest fear is a doctor not letting me go as big and I would like or not setting the limits for too big and my body being injured. Thank you for your time!
A: Selecting breast implant size is, by far, the most discussed patient issue in the breast augmentation procedure for understandable reasons. The whole purpose of the operation is to get a larger breast size. I do not choose what size implant any patient should have, I merely help the patient select a volume that matches their desires. There is no absolute science to selecting breast implant size but through experience and the use of shaped sizers, I found that the desired result is obtained in just about every patient. I personally have never had a patient who has undergone a reoperation to get a larger breast implant size because they didn’t get what they wanted the first time. Conversely, I have had a few patients that opted for bigger implants but it was because they chose a smaller size initially.
When it comes to size selection, here is definitely a growing trend and philosophy amongst many plastic surgeons to place implants whose size stays within the existing breast base diameter and does not exceed the ability of the breast tissues to support it long-term. When you look at the relatively high rate of breast implant revisions (nationally around 30% in the first three years after augmentation…my practice revision rate is less than 10%) it is understandable why a more conservative size approach has become popular. While the need for revisions comes from a lot of different reasons (infection, hematoma, implant failure, etc), very large implants potentially contribute to these causes. ( e.g., due to bottoming out, asymmetry, symmastia, breast tissue thinning ,etc)
What defines a large breast implant size or too large of a breast implant for the patient is going to be different based on each patient’s breast anatomy and chest/body size. For most patients, I would not think that going from an A to a D cup would constitute in my mind an implant that is too large or, more relevantly, places the patient at a substantially increased risk of subsequent breast tissue support problems. But that would have to be determined by an actual physical examination of the patient.
Dr. Barry Eppley