I have tiny 6" wrists and my biggest watch is 43mm. I have a couple 42mm as well, but the bulk are 41mm and under. The rest of my body is more average-sized than my wrists imply (5'9", 150 lbs) so 43mm doesn't look TOO huge on me, but it's definitely outside my preferred size range. It helps that it's a quartz and therefore relatively thin, and a diver, and therefore visually broken up by the bezel. A 43mm dress watch would look clownish on my wrists. My ideal watch is 36-39mm, depending on the style.
After making due with watches that I liked, but were rather large, I finally sucked it up and invested in some decent mid-size watches that look appropriate on my wrist. It's a little ironic that mid-size watches are generally considered unisex or women's watches, since they are still bigger than the watches that many of our fathers and grandfathers wore. I find the current trend of oversized watches pretty ridiculous - an oversized watch does not make you look manly, nor, in my experience, are the manly men the ones who tend to wear them. My dad is much bigger than me, 6'5" and probably 220 lbs (yes... I am his biological son and yes, I am a genetic freak in my otherwise tall family), and his 43mm Luminox is a perfectly fine size on him. The thought that people "need" watches that are 44, 46, or even 50mm+ simply boggles the mind.