They’re getting bigger. Trends in cosmetic surgery, that is.
Susie*, 34, moved to Orange County, California last year and along with her change of address came a change in bra size. The number of women getting breast enlargements and lifts has sextupled in the past decade. Susie, also a mother of four, is one of over 250,000 women who had breast enlargement surgery last year.
The preferred bra size is anywhere between boulders and mosquito bites. Yes, this means that “the perfect breast size” is a myth; it’s all a matter of personal preference. Many people are content with their breast size- A, B, C or D- and so are those attracted to them. But for many others who think their breasts are less than perfect, self esteem suffers. The latter group includes NEPA native Susie.
“I had four children. (My breasts) would blow up and down each time, and I nursed three out of four of the kids. I was a full B before I had kids, and I went to a negative A. I was shopping for training bras,” said Susie. ” I was 33 and done having kids. I wanted to feel like a woman again.”
Di, 37, a mother of three (five if you count the twins, as she calls them) from Wilkes-Barre had breast implants for the same reason nine years ago while she was living in Italy. But, Di’s story is a little different. She is on her second set.
“I decided to get them after my third child. You can fix your body; you can lose weight, tone- but you can’t make your breasts beautiful again. The first thing that goes (when you have a baby) is your upper body,” said Di. After almost ten years, the normal shelf life, one began to leak. She immediately made an appointment with Dr. Levandoski in Forty Fort for replacements- a size up. “They are more noticeable the second time around!”
Whether it is medically necessary or for aesthetic reasons, more women than ever are turning to breast augmentation and/or breast lifts, even moms like Susie and Di. And studies report that most women are happy with the results.
A Brief Overview
Breast enlargements (augmentation or mammoplasty), enlarge the breasts one or more cup sizes. Breast lifts (mastoplexy), reduce sagging. A lift can be done on its own, or after an augmentation. Implants, which can last between 10-20 years, can also be replaced and removed in later surgeries. According to WebMD there are several reasons people turn to augmentation:
– Enhance breasts people consider too small.
– Restore size or shape after significant weight loss or pregnancy
– Make breasts proportioned
– Reconstructions
Implants Implanted: The History
In the 60s, doctors began experimenting with silicone and paraffin injections, as well as sponges; methods deemed dangerous. In 1963, silicone implants were introduced; two years later, the saline implant. The 70s saw implants being mass-produced and in the 80s, they practice grew tremendously as the clinical experience of plastic surgeons increased. In 1991, debates and law suits over breast implants became prevalent. The Dow Company lost a multi-million dollar law suit when a woman claimed implants caused an autoimmune disorder. By 1992, the FDA banned silicone implants except for in clinical trials. Saline implants, dubbed a safer alternative, began to be widely used. Then, after 13 years, the FDA recently approved silicone implants from Inamed and Mentor.
Saline vs. Silicone
While silicone came under fire in the early 90s, many plastic surgeons still swear by, including the California surgeon who worked on Susie.
“I wasn’t going to go for (silicone), but my doctor convinced me when he had me feel them. They were so baby soft; they felt like a real breast,” she said. Susie added that in the past she had medical problems, and had they surfaced after the implants, she may have blamed her illness on them.
“I see how (the woman who sued) could think that. But, the research I read shows no more women with implants have auto-immune diseases than whose without them,” she said.
Di opted for saline; she may not have had another option. Her surgery was in 1993, one year after the FDA ban on silicone. She stuck with saline for her second set.
The differences between the two available implant types are how they feel, how they can change and what happens in they burst. As Susie mentioned, silicone are more natural, having a similar texture to breast tissue. They are made of semi-solid gel. Saline is a saltwater liquid, much like you’d find in an IV. Usually, once a silicone implant is in, it is in. The size of a saline implant could be altered by a needle injecting more fluid in, or taking fluid out after the procedure is done.
If a collapsed silicone implant would take longer to notice; but, one would know immediately if a saline implant ruptured. Since Saline is water, the burst fluid would safely be absorbed by the body whereas a silicone leak could cause scar tissue. However, many new silicone implants are designed to be leak-proof (see sidebar interview with Dr. Collini.)
Nice Pear!
Implants are available in two main shapes: round and pear-shaped (also called teardrop). Both Susie and Di opted for the round.
“Teardrops are natural. If I wanted natural, I would have left them alone,” she joked, adding that for $5000, she wanted them “out there.”
Most silicone implants are round.
The Procedure
Going shopping for a bigger bra means enduring anesthesia, pain and even suffering.
“I was scared! I wanted to run,” admits a doctor-phobic Susie, on how she felt the day of her surgery. “Sometimes I am still scared, having a foreign object inside of me.”
Women like Susie and Di first spend time learning about the procedures, deciding what size and type of implant is right for them and preparing for the big day. The mammoplasty procedure will take place at an outpatient center and lasts between one to two hours. General anesthesia is usually used, although sometimes local is given.
There are several variations to breast augmentation surgeries, but a WebMD article provided a detailed summary of a typical procedure. Whether the implant is filled with silicone or saline, the all implants have solid silicone shell. According to the medical reference website, this is positioned either under the chest muscle or under the breast tissue through an incision made on the bottom crease of the breast, the armpit, the nipple or lower edge of the areola. Depending on the specific type of implant, the breasts are either stitched up or can contents can be added or drained for desired size. Once complete, gauze is taped over the incisions and the breasts are wrapped in an elastic bandage or supported with a special bra.
Breast lifts, or mastoplexy, can be done at the same time to enhance the job. However, many women who have not had breast enlargement have breast lifts done simply raise sagging or dropping breasts. WebMD says this procedure is done by removing excess skin at the bottom of the breasts and areola. Then, the remainder is brought together. This tightens and raises the breasts. This procedure takes about the same time, and is also performed at an outpatient center.
Susie had both augmentation and a lift done, as well as an areola reduction. Because of the third procedure, she had a different technique used: the cookie cutter. They cut out her areola, slid the implant in through that hole, reduced her areola and stitched her back up. Susie’s breasts were actually uneven so she received 400 ccs of silicone in one, and 425 in the other.
The Recovery and the Results
There are several painful- yet bearable- side effects to breast augmentation and lifts, and the recovery process can take up to a month.
“I didn’t feel that bad the first day, but they did not look very good. They were really high. It looked weird,” said Susie, explaining that because the implants were placed behind the muscle, the chest area grew tight. “I was crying my eyes out and stayed in bed.”
The feeling of regret and pain is normal. Susie was sent home with papers on what she would feel emotionally and physically.
“After four weeks I felt really good and they began to drop nicely. I started to feel really comfortable.”
Di also had a rough recovery time, partially and ironically because she was in good shape.
“It hurt like hell. I had three kids, two cesarean sections,” she said of this being the worst pain she endured. Like Susie, she also had the implants placed under the muscle. Since I worked out, my muscles were toned and tight. It felt like a MAC truck was sitting on my chest. I did not anticipate that pain.”
Di adds that her second surgery was less painful, with the swelling to a minimum.
“My muscles were used to having something there,” she said. “It was easier because I knew what to expect.” Most women will have to go through a second and even third surgery, as implants need to be replaced every ten or so years, and eventually removed.
According to WebMD:
The pain, swelling and bruising can last for several weeks.
In seven to 10 days, patients can return to have stitches removed; the scars will start to disappear in a month or so. (Susie reports that she has very light scarring; her appendix scar on her abdomen in much more noticeable. To begin with, the procedures are designed to make minimal incisions and undetectable scars in well-concealed areas).
Some, especially those who receive lifts, will report a burning sensation in the nipples. Lifts can also cause dry breast skin.
Scars from lifts will be wider and can take up to a year to disappear, or could be permanent.
After this procedure, most should be able to return to work in a few days. But sorry boys- as tempting as it may be- no physical contact with breasts is recommended for about a month.
The Reaction and the “Are They Real” Question
Susie had full-C cup size implant, but with “what she already had” factored in, she fits into a D-cup bra. The results are more than she expected, bittersweet she says.
I sometimes feel that I am a little too big- I’m a little torn to be honest! I mean, when you are a D-cup, even if they are real, people question you,” she said. “My doctor says it’s perfect for my shape though. I do feel a lot better. I feel like a woman and I feel confident again!”
Di went from a small 34-A to a full-B/small C the first time, and her new set is also full-C cup.
“Sometimes I think I look funny, but not like Dolly Parton or Anna-Nicole Smith. They are proportionate to my body. How natural they look depends on how you dress with them,” she said.
Di added that a major difference with fake boobs is that when you take your bra off, the boobs stay in the same spot.
“Many people can look good in clothes, but when they are undressed, the boobs sag,” she said, adding another positive side to the implants.
Since Susie had her surgery done across the country and Di across the Atlantic, both say they had similar reactions when they returned to NEPA: Their relatives and close friends couldn’t wait to take a peek.
“My sister-in-law thinks they are beautiful,” Susie said, adding she was able to fool people she just met. I was at a party with a girl who did not know I had a boob job. She asked if they were real, so I told her to guess. After she felt them, she said, ‘I don’t feel an implant. They must be real.'” she said.
Di says her family had a lot of fun with her, after she flounced off her shirt revealing her new boobs in her new bra.
“It was a lot of humor. They told me I looked like Dolly Parton, asked if my back hurt,” she said.
Old acquaintances Susie ran into could tell something had changed. She reports that she can tell when people are giving her “are they real look”. But she knows they aren’t staring her; they are just curious, envious or both. Sometimes they ask.
Di agreed.
“I am not shy about telling people if they ask. I take it as a compliment. It makes That makes it worth the money,” she said.
The husband’s reaction
When asked if her husband liked them, Susie just had three words: “He’s a guy!” She added that he told her, aside from the wedding ring, they were the nicest thing he bought her.
Di admits her husband did not want her to have the implants, mainly because he feared for her having surgery.
“He loved me before and he loves me after. Well, he loves ‘them’ more after. I think he’d be sad now if they were gone,” said Di.
Years Later
Even breast implants can’t fight the sagging that comes with age, weight loss or gain or pregnancy. (For this reason, it is advised that women not have implants until they are done having children.) Most people who have implants will have a second surgery to replace an implant, or to have them removed. Susie plans on being a sexy grandmom, saying she thinks aging stars like Sharon Stone and Madonna look amazing.
“(Before the implants) I was 33 and (my breasts) looked like they were 50. Now, I want to look as good as a can for as long as I can. When I am 50, I may get them replaced, but probably not when I am 70.” Susie purchased a $100 lifetime warranty on her implants which will take care of any complications, as well as replacement implants. Most implants come with a five or ten year warrant to replace them, should a leak occur.
On the other hand, Di says, “They are part of my personality now. I will be the only 80-year-old with fake boobs wearing a low-cut shirt in the nursing home!”
The Verdict
Would Susie recommend a boob job?
“Only in cases like mine. If you are small and just want big boobs, I’d say no. Unless they are deformed, changed or are uneven, just be happy with who you are,” she said.
Susie said it was scary because it was risky. But she rationalized that, really, any medical procedure is. “Any surgery is a risk. Anytime you are put under, something could happen.”
Di feels that people should only do this procedure for “yourself.”
“If you want to make yourself happier, do it. If you want to color your hair or get your nails done because you like the way you look, do it. But, no one is worth changing for- to cut open your body to make someone else happy?”
Overall, both women feel better about themselves.
“I know I feel sexier about myself when I look in the mirror,” said Di, She added that’d she even consider liposuction next.
*Name has been changed.
Stats and Trends:
The following facts are from a 2004 report from the American Society of Plastic Surgeons:
The 1991 controversy of silicone gel implants did not scare away the masses.
In 1992, only about 32,00 breast augmentations were done.
In 2004, there were over 252,000- a 676% increase!
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On the Top 5 list of cosmetic surgeries in 2004, breast augmentation is #3, with rhinoplasty (nose job) coming in second and liposuction being the most popular.
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Who says your zip code has to be 90210 to take part in a still-growing cosmetic surgery trend? It can be 18702, too. Victoria Secret models and adult film stars take a backseat to the ‘common’ woman when it comes to getting boob jobs.
– 71% percent of women who have cosmetic breast surgery have household incomes less than $60,000 per year.
– Only 13% rake in over $90K.
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Northeast PA is keeping it real. When it comes where breast augmentations and lifts are getting done Region 5 (Mountain and Pacific states, like California) ranks highest with 31% of the cases. Region 1 (Middle Atlantic and New England states) ranks last, accounting for 11%, 30,011 procedures. For lifts, Region 1 also ranks last. (But, this region of the country ranks highest for butt lifts and lip augmentation!)
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Average costs:
Breast Augmentation, $3373
Implant Removal, $2211
Breast Lift, $ 3718
Male Breast Reduction, $2812
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Risks
– More difficult to detect breast cancer, as mammogram results are harder to achieve. To combat this, an MRI can be used. Also, implants placed under the chest as opposed to just under the breast allow for better mammograms.
– Capsular Contracture- this is when scar tissue hardens around the implant and beings to squeeze it. This can harden the breast, cause skin to ripple and change the shape. This can be painful and surgery is needed to either remove the scar or replace the implant.
– Loss of feeling in nipples or breast tissue due to nerve damage. This is usually only temporary.
– Different in size and shape can occur
– Changes to implant- normal activity or injury- can cause implant to leak, rupture or deflate.
– Infection, hematoma and abnormal scarring can occur, but these side effects are very uncommon.
Job Hunting?
Here are some local plastic surgeons, as listed on the ASPS website within 50 miles of 18702:
Ira C. Krafchin, MD- Wilkes-Barre and Clarks Summit
570-586-5000
Gerald Levandoski Jr., MD- Forty Fort
570-288-1600
Scot Robert McKenna, MD- Dunmore
570-340-6920
Eric W. Blomain, MD- Dunmore
570-347-1712
Robert M. Kimmel, MD, FACS- Hazleton
570-622-2900
Michael D. Lado, MD, FACS- Hazleton
570-366-2304
Atul K. Amin, MD, MBA- East Stroudsburg
610-258-3375
For a list of places in areas outside WIilkes-Barre, just do a quick Google search!
