In my various online activities, I have been asked if I have anything against big breasts or "Is this breast augmentation gone bad?" Put simply, there is a limit to how large a woman's breasts can be made without having an unacceptable risk of complications. Some women want the surgery anyway, but that is another story. I try to limit problems as much as possible. Reviewing cases for the California Medical Board over the last ten years has taught me that my own complications are mere shadows of those that some other California surgeons are facing. Everything is relative in cosmetic surgery.
-JPD
The bottom line here is that the reasons for limiting size in implant surgery are practical.
This isn't a Dr D patient. Her implants are so big that the skin envelope can't accommodate them. She has about a 100% chance of needing more surgery over her lifetime.
That doesn't mean that large breasts cannot be made from small ones. It just means that if you don't want guaranteed problems there has to be a limit. The woman below is one of Dr D's patients. She has very full breasts.
Before Surgery
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Four Months Following Surgery
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She has large breast implants, but not a cavernous cleavage. Her skin envelope isn't tightly adherent to her implants. She looks large but her breasts can bounce a little when she walks. They are soft. These are certainly larger than those of our average patient, but they don't look "too fake." Women that want to be much larger than this probably should find another surgeon. These are saline-filled implants placed "under the muscle." Saline-filled implants can look and feel natural as long as the soft tissue coverage is adequate. They also have a lower potential for hardening over time...about a third of that seen with silicone gel filled implants.
Women that want really large breast implants (3 cup size enlargement) should accept that they will likely experience some complications. They will have implants that are more easily felt and seen, a higher risk of contracture (breast hardening/distortion), rippling (visible "dents" from implant wrinkling that are visible through thin skin), droopy breasts (gravity works on larger breasts more than on smaller ones) and a higher chance of needing/wanting additional surgery later. As long as the patient is understanding of these issues and the requested breasts aren't truly enormous, we will offer the patient surgery. There is the risk for these problems with smaller breast implants. It is just that the risk gets larger as the implants do. Moderation is a good thing sometimes.
BREAST MAIN | SITE MAIN
© John Di Saia, MD... an Orange County
California Plastic Surgeon
Serving Southern California since 1997 * (949) 369-5932
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Please note that this resource is offered freely to individuals considering cosmetic breast surgery. No rights are granted and it is not to be reprinted or copied without the author's prior written consent. Understand that some of the information presented may be a matter of professional opinion. Although efforts have been made to assure accuracy, no guarantees are expressed or implied.
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