Choosing implant size is one of the most important considerations for patients undergoing breast augmentation surgery.  Recommendations will be made based on a patient’s aesthetic goals, chest wall and body measurements, and amount of natural breast tissue.  Trying on implant sizers is an effective tool when selecting implant size.  There are additional risks when selecting large breast implants, greater than the maximum size recommended from a surgical perspective.  What is considered a “large breast implant” will vary between patients given that implants are selected in terms of base diameter.  This measurement is determined by a patient’s breast and chest wall measurements.  A 350cc implant, for example, may be considered large for a petite patient with smaller breast base diameter than a taller patient with a broader chest.  Risks of large breast implants include the following:

  1. Increased risk of skin and breast tissue thinning

    • Large breast implants place greater strain on the skin and breast tissue.  This leads to greater risk of long-term skin and soft tissue thinning.  Patients may notice increased implant visibility over time, including rippling and implant palpability.
  2. Greater risk of ptosis (breast droopiness) due to skin stretch from large breast implants

    • Larger breast implants increase the risk of breast ptosis over time.  Aesthetic concerns relating to breast ptosis from large breast implants may motivate patients to consider mastopexy (breast lift) in the future.  This will place additional scars on the breast.  Patients will also incur additional expenses relating to further cosmetic breast surgery and taking time off work, etc.
  3. Greater risk of post-operative healing complications (e.g. implant exposure)

    • Large breast implants place additional tension on the wound closure.  In patients with thin soft tissue coverage, this may increase risk of wound healing complications due to greater tension.  This risk also increases in association with smoking and other medical conditions.  In rare cases of implant exposure, this may necessitate temporary removal of the implant and/or implant downsizing.
  4. Greater risk of discomfort from the weight of large breast implants

    • Due to added weight from large breast implants, patients may experience back, neck, and shoulder pain.  These symptoms are commonly experienced by women considering breast reduction due to hypermastia, but may also be experienced by augmented patients with large breast implants.
  5. Greater risk of nipple numbness

    • There may also be increased risk of nipple numbness in association with large breast implants.  This added weight may place additional tension on the sensory nerve supplying the nipple.  Although this numbness may be temporary and resolve over a few months post-operatively, there is risk of permanent sensation change.

Please contact us if considering breast augmentation in the Toronto area to schedule a consultation.  Dr. Power will carefully listen to your expectations of breast augmentation and then make recommendations regarding implant size based on your goals and clinical presentation.

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