Patients who request disproportionately large breast size from breast implant surgery must consider that such a choice can place them at risk for a less than optimal long term outcome and the need for re-operation and additional expenses. The placement of excessively-sized breast implants exceeds the normal dimensions of the breast, produce irreversible tissue thinning, implant drop out, visible/palpable rippling, and implants that are too close together at the center of the chest (synmastia). Large volume primary augmentation or revision with larger sized implants (>350cc) may increase the risk of complications such as implant extrusion, hematoma, infection, palpable implant folds, and visible skin wrinkling requiring surgical intervention to correct these complications.