The obvious main objective of undergoing breast augmentation surgery is to make one's breasts bigger, however; once the initial decision has been made, you will be faced with the question of just how big your new bust should be. Most can readily agree that a “ZZZ" is grotesque, but where is the line? How big is too big?

What Are My Options For Breast Implant Sizes?

Saline breast implants are available prefilled or filled after the shell has been placed. Silicone breast implants come in standard sizes based on volume, ranging from 80 cc to 850 cc. It is technically possible to order breast implants in custom sizes if a woman wants an implant to be larger than what the standard options are. However, be advised that surgeries for custom-sized implants must be performed outside of the United States, because manufacturers will not produce implants larger than the current standard for the U.S. market. This means that those unable to add travel to their surgery costs, or feel uncomfortable having surgery in a country where regulations may not be as stringent should forget anything above 850 cc.

What Are The Disadvantages Of Super-Sizing My Implants?

Although 850 cc will technically be the limit for most American women, that is still a very large implant. When converted into cups, 850 cc is just over 3.5 cups of volume. Pour this much water into a Ziploc baggie (you'll need a quart-sized one to do it) to measure the amount of volume each individual implant would occupy.

Keep in mind that this implant would be placed below existing breast tissue, meaning your breasts would be even larger. Among the downsides of implants at the larger end of the spectrum are:

  • Incision length: Large prefilled implants require a longer incision. This may increase the visibility of a scar depending on incision location.
  • Restrictions on incision type: Extremely large prefilled implants can be difficult to insert with certain types of incisions. For example, only some surgeons are able to use a periareolar incision for implants as large as 700 cc, and no matter what they claim, always ask to see “after" pictures of patients who have had this done.
  • Skin affected: All implants will affect the tissue (breast tissue and skin) above. Larger implants will be more likely to cause stretching and other issues, and heavy implants can make skin (and by extension, breasts) sag too.
  • Disproportionate appearance: If an implant's size doesn't match your frame, it probably won't have the aesthetic benefit you are trying to achieve by undergoing breast augmentation in the first place.
  • Bottoming out: Extremely large implants have a much greater chance of shifting out of place than smaller implants. This phenomenon is called “bottoming out" and makes the nipple appear too high on the breast.

So Where's The Line? How Big Is Too Big?

According to follow-up studies of women who received implants, sizes larger than 350cc were associated with elevated risk of complications like: hematoma (mass of blood), extrusion (implant pushes through the incision site), skin wrinkling and detectable implant folds (the implant can be seen and felt under the skin). In most cases, surgical revision was required.

Therefore, 350cc may be a good starting point to discuss with your doctor if you are interested in large implants. However, although it is important to consider the above issues when choosing your implant size, ultimately, you should go with what you want after talking to your surgeon. According to one of the chairs of the American Society for Aesthetic Plastic Surgery's Breast Surgery Committee, 34 percent of women who have an additional surgery do so because they want larger breasts. If you realize you are agreeing to a smaller size because you feel like you should, be honest with your doctor about your goals for augmentation.