David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

Breast Implants: How To Know When You’re Going Too Big

Woman determining the size breast implant that will fit her body best with Dr. Reath

A recent phenomenon that I have noticed is that women are choosing larger and larger breast implants when having breast augmentation. The average implant size has gradually increased over the years that I have been performing breast augmentation for Knoxville and Cookeville, TN, women. I am left with two questions: is there an upper limit in sight? And how big is too big?

About 20 years ago, the typical implant volume was less than 300 cc. It was quite rare to go far above that, or even into the 400s. Today, I rarely use an implant smaller than 300 ccs, and I commonly use implants in the 400s. Additionally, I am not infrequently using implants that are 500 ccs or even slightly more. So what is driving the escalation in breast implant size, and how much is too much?

Why Women Are Choosing Larger Breast Implants

I do not think there is one single thing that is causing women to want larger breast implants. Several factors are contributing to the trend.

Advice From Friends

Women frequently tell me that they have been advised by their friends who have had breast enlargement to go a little bigger so that they will not be disappointed. Many women tell me that they feel after having had the surgery that they would go bigger if they were to do it over – even though some of these women are now wearing a D cup after surgery.

Now, let me point out that these women are not kooks or unreasonable people. There can be a change in the desired breast size after surgery. Some women who, before surgery, are concerned about going too big, find that once they have the operation, they get quite comfortable with their new size and would like to go bigger. So expectations and desires can change, and some women may go larger initially in anticipation of this.

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Changes in Fashion

Fashion is influencing the change. It is more common to find models who are larger in the chest— particularly swimsuit models. It just seems that bigger breasts are “in.” Therefore, women want larger implants.

Increasing Empowerment

Probably the most important factor is that women have much more say in the size of breast implants chosen than they did previously. Going back to 20 years ago, I would talk with a woman about her desires and then select the implant size for her.

Now every woman who comes in works with sizers. They put on a bra with different sized implants, put a t-shirt on over it, and look at themselves in the mirror. I will advise on size, but the patient is the one who is calling the shots – for the most part. So the increasing size of implants over the years reflects women are getting what they want. And this is great as long as we don’t go unreasonably large.

How do I know if my breast implants are too big?

Patients often ask this question. I once heard a prominent plastic surgeon say that he would never use implants over 350 ccs. To me, this is arbitrary and ridiculous. It could be too large for a very petite woman and not nearly large enough for a very tall woman with a broad chest.

Keep in mind that there is no perfect size, a topic I discussed in this blog post. I frequently tell patients that if everyone were between a very full B and moderate D cup, I would be out on the street corner with a sign that says, “Will Operate for Food.”

Physical Constraints

What women will find if they have overdone it with implant size is that their breasts can get in the way of physical activities, can cause shoulder and neck pain, and may make it hard to find clothes that fit. Also, higher weight in the breast can lead to sagging of the breast due to the weight of the implants.


There is another, more aesthetic concern, at least for me. A full breast is very attractive. This probably represents a full C or D cup. Going larger than this in many women will not look as beautiful because their body is now out of proportion with the breasts not fitting the body. And sometimes, these larger implants make women look broader in the chest, not necessarily larger in the breast. This can make women look heavier— not exactly the look most patients are trying to achieve!

So, again, how do you know if you are going too big? I think this depends upon your body size and type, what your physical activities are, and perhaps your profession. But maybe the key here is how to maintain proper proportions to your body. And for this, I cannot give specific sizes.

How do I choose my breast implant size?

As you try on sizers, don’t just think about how you will look in a bathing suit or halter top, but think about your physical activities as well as the kind of clothes that you will wear every day. Keep these pointers in mind as you consider potential implant sizes:

  • If you are short or have a narrower chest, you will be better off in the lower range of implant sizes. If you are tall or have a very broad chest, larger implants may look better. In this regard, it is rare to need implants larger than 450 t0 500 ccs. But in someone who is 6 feet tall (and, yes, I have patients like this), 500 ccs may look somewhat modest.
  • If you are very active in sports, especially higher impact sports like running or kickboxing, you will want to not go over the top in size, or your breasts may get in the way. While some great sports bras can help, it is tough to find marathoners who wear a DD bra.

This video offers additional helpful tips for choosing the right implant size for your goals:

My goal in all of this is to give women what they want, not just today but throughout their lifetime. If that means a modest increase in breast size, great. If it means going very large, that can be good too. But I want to try to avoid creating a disproportionate figure or creating a problem later in life where the weight of the implants and the size of the chest are too much. The other issue is that I want to make the breasts look good. This can be difficult if the implants are either too big or too small for the size and shape of both the natural breasts and the chest itself.

Yes, You Can Go Too Big

The bottom line here is that you can go too big. One of my blog readers coined the term “booby greed.” But there is no specific number of cc for everyone. Everyone is different, and everyone wants something different. We will do our best to guide you to something that looks great both today and tomorrow, as well as something that will fit your body and your lifestyle.

To see examples of the results you can expect, take a look at my patients’ before-and pictures showing their silicone and saline implant results. If you’re interested in starting your breast augmentation journey with an experienced plastic surgeon in Knoxville, TN, please contact us online or call (865) 450-9253.

All the best,
Dr. David B. Reath

David B.Reath, MD

Note: This blog post has been updated.

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