While areas of many simple surfaces have been known since antiquity, a rigorous mathematical definition of area requires a lot of care. Various approaches to defining the surface area were developed in the late nineteenth and the early twentieth century by Henri Lebesgue and Hermann Minkowski. For a very wide class of geometric surfaces called piecewise-smooth all these approaches result in the same notion of area. However, if a surface is very irregular or rough, then it may not be possible to assign any area at all to it. A typical example is given by a surface with spikes spread throughout in a dense fashion. Many surfaces of this type occur in the theory of fractals. Extensions of the notion of area which partially fulfill its function and may be defined even for very badly irregular surfaces are studied in the geometric measure theory. A specific example of such an extension is the Minkowski content of a surface.
The surface area-to-volume ratio (SA:V) of a cell imposes upper limits on size, as the volume increases much faster than does the surface area, thus limiting the rate at which substances diffuse from the interior across the cell membrane to interstitial spaces or to other cells. If you consider the math, you'll see the relation between SA and V much more intuitively: V = 4/3 π r3; SA = 4 π r2, where r is the radius of the cell. Do the math and the resulting ratio becomes 3/r. If a cell has a radius of 1 μm, the SA:V ratio is 3. Increase the cell's radius to 10 μm and the SA:V ratio becomes 0.3. With a cell radius of 100, SA:V ratio is 0.03. Using the previous simple example, we can see how the surface area falls off steeply with increasing volume.
What limitations does this place on a living cell? For small cells, SA:V ratio allows for relatively good exchange of nutrients and wastes. For larger cells and organisms, SA:V ratio forces the cell or organism to find more efficient ways to exchange nutrients and waste products, e.g. specific conduits that carry blood, hormones, lymph, etc. from deep regions to the surface of an organism.