In most cases of breast augmentation, women usually desire predictable and reasonable increases in their breast size. (implant sizes of 300cc to 500ccs) Occasionally, maybe once or twice a year in my practice, someone will want really large breasts. A size that is disproportionate to their body frame but still able to be achieved with standard off-the-shelf implants sizes. (standard implant sizes go to 800cc for prefilled silicone and 800cc for saline which can be filled to roughly 1000ccs)
But the recent world record for breast implant size reached an astronomical increase of KKK. As recently reported a Houston Texas woman had her tenth breast augmentation surgery (performed in Brazil) to reach the gigantic size of 3,500cc per breast! Besides questioning the sanity of any patient who would even want to go half that size, it is not a very proud moment for plastic surgeons. While I am all for helping patients achieve what they want, not everything that some patients want is actually good for them…….and we as plastic surgeons should not be afraid to say so. Yes it is true that patients will go ‘down the street’ and find someone else to do it….there is a time to let them do so.
While such an extreme breast implant patient makes worldside news, the occasional patient who wants to be really big, by more normal standards, is more commonplace. When women make a choice for a large breast implant, they need to understand the long-term consequences. And there will be some. Most pertinently, there will be a day when the patient will not want to be so big. Downsizing breast implants will always make the breast sag…and many women will want a lift which results in breast scars. It is easy to go big, the skin will stretch and be nice and tight, but going down is another matter. The breasts will be deformed and will require some degree of skin tightening. Large breast implants over time will weaken the soft tissue support of the skin and many such patients will develop bottoming out of the implant over time as this support is lost.
In short, large to extreme sized breast implants are unnatural and the breast tissues are not designed to support such weight and size over time. When downsizing of a large breast implant is wanted, the loose size and large underlying breast implant pocket must be managed in a more reconstructive breast approach. This results in scars and may require multiple surgeries to get an acceptable shape and result. For these reasons, I advise patients to think very carefully about making breast implant size choices that exceed what their breast tissues are designed to handle. What size that is will vary greatly based on the patient’s breast and chest wall anatomy. There is no absolute upper implant size that applies to everyone.
Dr. Barry Eppley
Indianapolis, Indiana