One of the most common questions patients ask our plastic surgeons involves determining the correct size of the breast implant as part of a breast augmentation procedure. For patients who want to choose bigger breast implants, the question is how big can they go. In terms of cup size, many patients want to know what volume will give that desired increase. The obvious concern with any breast augmentation procedure is choosing a breast implant that you feel is not big enough and therefore regretting your choice of implant size in the postoperative period.
There are several factors to consider when deciding to undergo a breast augmentation in London. We always recommend all patients undertake as much research as possible and speak with friends or family who may have had breast augmentation previously. You may already have an idea of the approximate size of the implant which you would like to have. For many patients, this is when they will begin to feel very excited as having a breast augmentation is an investment in yourself for renewed self-confidence.
At the face-to-face consultation with the surgeon, a key aspect of the discussion will centre around an emphasis on the maximum size limit of breast implants for your anatomy. Many patients can feel a little disheartened if their anticipated implant size does not fit with the advice given by their surgeon. This is the point many patients will ask “why can’t I go bigger?”.
Pregnancy and breastfeeding after breast enlargement
Understandably, patients may be a little disappointed at this point but fortunately, this does not mean that you will not be able to get the result that you have been aiming for. In virtually all cases there are well-founded reasons why your surgeons may advise against a particular size of the breast implant and these include both the effect on your soft tissues as well as the risk of implant-related complications.
The risks of choosing overly large breast implants
The anatomy or structure of the patient’s chest will be the most important factor in determining the most appropriate size of breast implant for you. At the consultation, your surgeon will carry out several key measurements of the chest to offer customised treatment specific to you and that will deliver the very best possible results most safely. The anatomy of your chest wall determines many factors from the type of breast implant which is used to the position of the implant whether sub-glandular or dual plane and also the type of incision used for the breast augmentation. The most common type of incision for breast augmentation surgery is the inframammary approach.
Breast implant incisions and positioning
Many patients will have a minimal amount of breast tissue and may also have a tighter skin envelope. This means there are fewer options for implant sizing compared with a patient who has more breast tissue and a less tense skin covering. It’s important to emphasise to patients in the first category that the surgeon is focusing on putting your health and safety first and to ensure the results are both significant and natural-looking for your body shape. In both types of patients, if the surgeon were to insert an oversized breast implant with the patient’s anatomy then there would be a significantly increased risk of complications that may not look aesthetically pleasing and could lead to medium to long-term issues in the worst-case scenario.
One of the key risks in inserting oversized breast implants involves possible implant malposition where the implant does not sit in its desired position. In severe cases, there is even a risk of developing a condition called symmastia, also known as a “uni-boob”. Symmastia is the term used to describe a lack of cleavage between the breasts and is often due to excessive pressure exerted by the implants on the soft tissue. Very large implants can also end up dropping a lot lower than the inferior breast fold and this is also referred to as a “double bubble” appearance. The risk of implant bottoming out can also develop where the underlying soft tissues lose their structural support as a result of the weight of the heavy implant. This then leads to nipple malpositioning whereby the nipple tends to point upwards and a lack of upper pole fullness.
Large breast implants that are too big for your body frame also carry risks of visible skin rippling and the edges of the implant may be felt or even seen. Most patients and their surgeons will agree that these are not cosmetically acceptable outcomes and can also lead to a significant degree of social embarrassment as well as a great deal of pain and discomfort. Often these patients will require breast implant replacement surgery to address the problem of oversized breast implants. Our philosophy at Centre for Surgery in London is to assess patients thoroughly and formulate a sensible treatment plan to make sure that patients achieve the results they deserve without the need for a revision procedure three months later. This is why doctors will emphasise that there is a size limit to choosing the right size of breast implant for you.
In the most serious cases, there may be a risk of reduced blood circulation to the breasts. This is due to the very large breast implant exerting a high level of compression on the surrounding tissues which can lead to impairment of blood flow and in the most severe cases this could lead to skin necrosis or skin loss. This is a complication that can be avoided by choosing breast implants that are not too big for your frame.
The importance of correct planning for breast implant sizing
At Centre for Surgery in London, our surgeons are highly experienced in all types of breast augmentation surgery including complex revision surgery and have advanced tools at their disposal for accurate breast implant sizing. Our surgeons always aim to carry out bespoke planning for every breast implant surgery they carry out as every patient has unique characteristics and different expectations for treatment.
Breast implants do impart changes to the breast over time. All breast implants we use have the most comprehensive warranty for both capsular contracture and implant rupture. Our surgeons use both Mentor breast implants and Sebbin breast implants. Your surgeon plans for not only the immediate post-operative appearance but how your implants could look 5 to 10 years postoperatively. Choosing the most appropriate sized implant will help to minimise the impact of excessive thinning or stretching out of the soft tissues of the breast. Both of these soft tissue changes can lead to implant edges becoming more visible, breast ptosis or sagging and visible rippling of the implant.
The main priority with properly performed breast augmentation surgery is to create results that both look and feel natural using tried and tested techniques involving the lowest risk profile. Our medical practice is centred around optimising both aesthetic results and your health and safety with every procedure we carry out. Everyone at Centre for Surgery is focused on making sure you get your desired appearance. By coming in for a face-to-face consultation with the surgeon at Centre for Surgery, you will receive honest and accurate medical advice that is based on your needs and preferences. In virtually all cases, you may be asked to try on a variety of different implant sizes to get an idea of how you could look after surgery and your dedicated patient coordinator will be able to act as your point of contact throughout all stages of your patient journey.