Reasons for Breast Augmentation as Varied as Patients


Beth Longware Duff, Medical Editor

Beth Longware Duff is an experienced writer and reporter whose work on a wide variety of topics has been published in numerous newspapers and magazines. Her health and medical writing credits include nationally distributed videos for the March of Dimes Birth Defects Foundation, and she is the recipient of numerous awards including an American Cancer Society Media Award and a New England Press Association Award for Health Reporting. She holds a degree in Communications from Ithaca College.

April 22 2008

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When you hear the words "breast augmentation", the first images that pop to mind are probably movie starlets, fashion models and ladies-who-lunch in Beverly Hills. The stereotypical breast job patient is a youngish woman who's primarily interested in a bigger and better chest that will make her stand out from the crowd. In reality, that's just not the case.

In 2007, more than 348,000 women in the United States underwent breast augmentation plastic surgery (also known as augmentation mammaplasty), a 284% increase over 1997, according to the American Society for Plastic Surgeons (ASPS). In fact, breast augmentation has been one of the top plastic surgery procedures in this country for the last 15 years, competing with liposuction, nose reshaping and eyelid surgery for the top spot.

But why is breast augmentation so popular, and who's having it done?

Obviously, the desire to improve one's looks is the bottom line for women who choose this procedure. Other motivating factors include improved surgical materials and techniques, shorter recovery periods, direct marketing to the consumer by plastic surgeons, popular cosmetic surgery TV shows, and the allure of the pervasive celebrity culture.

But talk to a board-certified plastic surgeon like Michele Shermak, MD, and you'll learn that the reasons for breast augmentation are as varied as the women who have it done. An ASPS spokesperson and chief of plastic surgery at Baltimore's Johns Hopkins Bayview Medical Center, Dr. Shermak is the first to admit that her practice is about as far from the glitz and glamour world associated with breast augmentation as it can get.

"Here in Baltimore we're pretty conservative," she says. "A lot of the women that I see are looking for the ‘Mommy Makeover'. It's mostly a body image issue for them, getting back the volume they've lost after pregnancy and as they age."

The "Mommy Makeover" – a cosmetic surgery package that usually includes tummy tuck, breast augmentation and breast lift procedures – is indeed popular. More than 344,000 tucks, augmentations, and lifts were performed on women ages 20 to 39 last year alone, according to ASPS. Search the phrase online and you'll find tens of thousands of references – many of them prominently featured on plastic surgeons' commercial websites.

Older sisters (and perhaps mothers) of "Mommy Makeover" converts may be inspired by what they see. Dr. Shermak says she's also seeing a lot of women in their late 40s and 50s who have thought "long and hard" and decided to regain the more youthful figure that was once theirs.

Women who want to replace their implants are also returning to the operating room, either because the implants have run their course or because the women would like to swap out saline for silicone. Silicone implants, first developed in 1961 and banned in the U.S. by the FDA in 1992, were reintroduced in late 2006.

"Women weren't happy with the saline implants, and many were sitting at home, waiting from month to month for the FDA decision," explains Dr. Shermak, who adds that the silicone implants generally look and feel better than saline implants.

Breast reconstruction comprises another category of breast augmentation patient. It includes women who've undergone mastectomy and want to rebuild their breasts, teens with a congenital deformity like Poland syndrome (a rare birth defect characterized by underdevelopment or absence of the chest muscle), and a growing number of women who have a genetic predisposition for developing breast cancer.

"A lot of the time they're 20- or 30-year-old women who come in and decide to have mastectomies done because they don't want to be concerned about developing breast cancer," Dr. Shermak notes.
As for what the future holds for breast augmentation, Dr. Shermak is optimistic that it will remain among the top cosmetic surgery procedures and that it will continue to be a safe procedure, particularly in light of the scrutiny that's being placed on the new silicone breast implants.

"We're looking at millennium implants now. We're only a year-and-a-half [since FDA reapproval] into these implants, but the patients are very happy with them and I have to expect that they'll do better than the ones in the past," she says. "The implant companies are being watched very closely by the FDA, so I can't imagine them turning out a product that would fail."