Consequences of Having Very Large Breast Implants
Most women in Las Vegas want D sized breasts. Our average implant size for breast augmentation (450 cc) exceeds average implant sizes (250-300 cc) that are used most frequently for breast augmentation in other parts of the world. While many women are well developed, broad or tall, and have the physique to accommodate a large implant, others are thin and very petite, lacking tissue and the room to fit enormous breast implants.
It always surprises me when a very petite woman comes in for a breast augmentation consultation and reports that during her last consultation with a plastic surgeon she was recommended to go with 600 cc high profile breast implants. I hear this about once per week and it never fails to shock me. How do you fit a 600 cc implant in a woman who is 5ft tall, 95 lbs, flat-chested and with a breast width much narrower than the width of the breast implant?
Because skin stretches (think pregnancy), it is technically possible to insert disproportionately large implants in someone’s chest. But the very real consequences are surrounding tissue destruction that can be progressive, uncorrectable, and deforming.
I have a 25 year old asian patient I just saw in my office who is 5’1”, 100 lbs, and has 650 cc high profile implants. She wants to be smaller breasted. Sounds straightforward, but this is a complicated problem. Her tissues have severely thinned from the pressure of the implant over the last several years. Even though her implants are under the muscle, the implant edges and shell are visible on the entire surface of her chest. Skin rippling and wrinkling occur in her cleavage area. Her skin is stretched out, loose, and saggy, and she is only 25 years old! When I removed her implants, her chest wall and ribcage was deformed, sunk in from the pressure of the implants like 2 cereal bowls. Reconstructive efforts involve various degrees of pocket tightening, skin envelope tightening in the form of a breast lift with permanent scars, and new smaller implants, with the adjunct of fat transfer and/or tissue substitutes such as Strattice or Alloderm to support and pad the new implant.
Disproportionately large implants damage surrounding tissues permanently. And no, a simple switch from saline to silicone implants is not going to fix this problem. Clearly, larger implants will not solve this problem either, but I get asked that question a lot. Large breasts with voluptuous cleavage sounds desirable in the here and now, but all breast augmentation patients need to think about the longevity of their results. Huge implants in tiny bodies have much higher risks of complications. Reoperation to improve upon these problems is complicated, high risk, and expensive. In some cases, deformities are uncorrectable. It is very sad when a beautiful young woman looks great in clothes, but what is hiding underneath her bra is a disaster you cannot fix
