Breast implant size and likelihood of complications are directly related: the larger the implants, the greater the chances of experiencing a host of complications like implant rippling, stretching of the skin, bottoming out, “uniboob”, asymmetries and many others. Based on extensive personal experience with breast enhancements, my rule of thumb is that any implant larger than 350cc is considered a larger implant.
There are a number of considerations that can help your surgeon decide what is best for you—the size you prefer, the shape and size of your breasts and chest, and most importantly the quality of your skin and tissues. Consider breast implants as weights. The mass of the implant will stretch out your breast and will thin the tissues and droop in the direction of gravity; down when standing and off to the side if back sleeping.
Larger breast implants are suitable for larger women with excellent tissues, but not so in thinner, smaller patients who will eventually experience changes that are bothersome and unattractive. One simple analogy I share with my patients is that you can’t land a 747 on an aircraft carrier. Another saying is, “The bigger you are, the harder you fall.” Some surgeons even use “dimensional analysis” to help them determine the best implant fit: calculations are made based on measurements of your breast and chest as well as the pinch thickness of your tissues in several places. Most experienced surgeons can easily determine the best implant for your anatomy based on a simple visual inspection and examination.
If your surgeon allows you to simply pick whatever size you want without educating you on the pitfalls of your size selection, you have not been fully informed about the potential consequences. In my practice, with breast augmentation patients, most of my time is spent discussing size, fit, and proportional analysis, as well as a frank analysis of the pros and cons of the implant size.
To learn more about breast augmentation from a surgeon who is honest, experienced and values transparency, I recommend you read my Breast Augmentation Article. Remember, too much of a good thing could lead to dissatisfaction.