Breast Augmentation: Why Can’t I Go Bigger?

January 07, 2022

One of the biggest questions breast augmentation patients grapple with is which size of implant will be the right choice for them. It makes a lot of sense—you want to go bigger, but how big? What volume is going to give you the cup size you’re aiming for? If you don’t choose a big enough implant, will you regret it after your recovery?

It’s understandably a LOT to consider. And if you’ve been doing a lot of research while planning for your consultation, whether that means scoping out information online or speaking with friends who have breast implants, you may have settled on a theoretical implant size you want for yourself. And probably this is the moment where things are starting to feel really exciting. You’re on your way to making this big change for yourself that you’ve wanted for a long time, and you can envision your result.

But then you hit a road block. You meet with your surgeon and they tell you there is a limit to the size of breast implant that will work for your breast augmentation and you can’t go bigger. Suddenly what was exciting feels a bit disappointing and frustrating, and what you had envisioned feels impossible.

In that moment you probably want to know: are you sure? Why can’t I go bigger?

We totally get your disappointment and frustration. The good news is, just because the volume of implant may be smaller than you were anticipating, it doesn’t mean that the result you envisioned is impossible. Not at all. But there are definitely reasons why you may be limited in the size of implant you can choose, both in terms of your health and safety, and in terms of the look of your end result. Here’s everything you need to know.

Your Anatomy & the Risk of Complication with Going Bigger

This is the biggest factor that will limit the size of breast implant your plastic surgeon can use. Your surgeon will take a lot of very careful measurements of your body in order to calculate an approach to the procedure that will deliver the best and safest result possible. Your anatomic starting point will affect many aspects of your breast augmentation, from the type of implant (silicone vs. saline-filled), to the implant placement (subfascial vs. submuscular) and the incision location (armpit? breast crease? around the nipple?). And it’s no different when it comes to implant size.

So if you’re someone who has less breast tissue to begin with and if you have a tight skin envelope where the implant will be placed, you’re someone who will have more size limitations than a patient with more breast tissue or a looser skin envelope. This isn’t because we’re just straight up mean to the first category of patient, but because we want your procedure to be super safe and for your result to look as incredible as you deserve.

And really, in either case, if we were to place an excessively large implant relative to any patient’s anatomy, we would be putting them at risk for a number of complications that at best don’t look great, and at worst create serious health risks.

In terms of cosmetic concerns, an implant that’s too big has a higher chance of becoming displaced or malpositioned. It can lead to symmastia, perhaps more popularly (and uncharitably) known as “uniboob” where there is a malformation or absence of cleavage between the breasts. Excessively large implants can also lead to a double bubble deformity, where the implant comes to sit lower than the inframammary crease (or bra crease). Similarly, it can cause the implant to bottom out, where a lack of tissue support for the heavy implant leads it to fall too low on the chest, creating a nipple position that is too high and a lack of volume in the upper pole.

A breast implant that’s too big can also cause less serious but nevertheless undesirable cosmetic outcomes, like visible rippling and very palpable or noticeable implant edges. These are not the kinds of results our patients are looking for, they can cause a lot of discomfort and embarrassment, and would require revision surgeries to correct. We always want to get it right the first time, which is why our doctors will let you know a size limit.

Even more concerning, though, is the risk of vascular compromise. If breast tissue is forced to overstretch around an implant that’s too big, it can impede the blood flow and, in very rare and extreme cases, potentially lead to skin loss. This is just not something we’d ever want to risk.

Your surgeon has a plan. Your implant size is part of it.

If you’ve chosen a highly qualified, board certified plastic surgeon with a wealth of knowledge and experience, you can trust that they have a meticulous plan for you. At The Plastic Surgery Clinic, our surgeons totally customize every procedure since every patient is unique and different.

Your surgeon will also consider how the implant will impact your body over time. Your breast implants are guaranteed for life, and so we always want to think about not just your immediate result after recovery, but what will happen 5 or 10 years down the line. Your surgeon will help guide you to choose an implant size that won’t cause excessing stretching or thinning of your breast tissue, as that can lead to detectable implant edges, visible traction rippling and sagging of the breasts (or ptosis).

Our number one goal is to create a result that looks and feels natural and comfortable using techniques that create the lowest risk possible. That’s basically what we’re known for. Your breast augmentation should be specific to your body and to your realistic goals and expectations. The more you deviate from these characteristics, the more unnatural or “fake” your result will look.

If we can’t go bigger, we are not going to mislead you and suggest it’s possible. You need to have as much information as possible before going ahead with a serious decision like surgery. We’re here to help you get as close to your dream look as possible. Come see us for a free consultation and you’ll hear advice directly from our surgeons as they carefully examine you in person. They’ll help you try on sizers and get a good sense of what different implant sizes can do for you.