I know this question is going to sound ridiculous in this forum, since most perpetual Pateks (and non-perpetual) have traditionally been smaller than 38mm...
I have a 5146g and at 39mm it feels great...but possibly just about the limit of what I like. I also have a 5980 and a 5167, and outside Patek I am a Paneristi...so that tells you all.
But I feel more and more tempted about the dial of the 5159g... What do you guys think?? I know that depending on the design of the dial some watches may appear larger than their actual size. I would argue this is the case with the 5146g... Is it true for the 5149 too?