Anatomy of Fitness

SILICON OR BUST

Big breasts are still big business. Augmentation mainmoplasty, more commonly known as breast enlargement, is performed more often than any other cosmetic surgical procedure, edging out nose jobs, face lifts, tummy tucks and others.

More than half million women a year are augmented in the United States, and the numbers are growing. So is society’s acceptance of artificial enlargement. Whether for aesthetic reasons or for reconstructive purposes following a mastectomy, a woman’s decision to receive silicon implants is no longer met with raised eyebrows.

As a leading plastic surgeon in Dallas, Dr. Vasdev Rai sees all sides of the issue. His office is tilled with photograph albums of “befores” and “afters.” Rai carefully screens his patients, sometimes refusing the operation if he thinks a patient is trying to substitute breast enlargement for achievement or self- worth. “Some women think that breast augmentation will change their life:’ he says. “They’ve been trying to find an excuse because they can’t achieve something.” Often, says Rai, these women will ask,
“Hey, doc, what can you do for me?” “They don’t know what’s wrong with them, but they want me to fix it,” he says.

But for others who sincerely want to enhance their appearance and have talked of a breast operation for years, Rai is supportive. He walks his patients through the process, explaining each step, confident that “it’s going to make them feel good about themselves.”
Rai finds that some women simply demand too much of his specialty, unaware that no surgical magic can turn Carol Burnett into Dolly Parton. “Many patients don’t realize that plastic surgery has its limitations:’ he says. “They bring in a picture that they want to look like. I can only improve on what they have’

America’s perception of “perfect” breast size appears to grow larger from east to west. According to Dr. Fritz Barton, chairman of the plastic surgery department at Southwestern Medical School, East Coast surgeons on the whole use smaller implants than Midwestern surgeons, and Midwestern surgeons use smaller implants than those on the West Coast. (In layman’s terms, that means a B cup in New York and a C in the Midwest, rounding out with a D in California.)

While breast augmentation may get all the headlines, it’s only a part of the picture. Breast reduction, uplifts and recontouring
are gaining ground, and not just for cosmetic reasons. Heavy and large breasts can pose several health problems, including shoulder and back pain and poor posture as well as difficulty in self-examination for cancer. (Since these operations may be undertaken for health reasons, insurance companies may cover the cost.)

In recontouring, the breast is neither enlarged nor reduced but the shape is changed. resulting in a more youthful, firmer look. Augmentation or reduction can be combined with this operation. The cost for cosmetic breast surgery ranges from $2,000 to $3,500.
In the area of reconstructive surgery, breast surgery is more than a medical procedure—it’s a vital step to help a woman put her life back together after a mastectomy or double mastectomy. In this surgery, one or two breasts (including nipples) are actually created by the doctor, using silicon implants and the patient’s own skin and tissue.
Rai cautions women to know who their plastic surgeons are. Many doctors practicing various plastic surgery procedures have not. been certified by the American Society of Plastic and Reconstructive Surgeons (ASPRS). “Ask if they are board-certified,” he says.