Breast Augmentation: Lessons Learned From 56,000 Breasts

I’ve examined a lot of breasts – at least 56,000 – during my career as a plastic surgeon. How’d I get to that number? About 7,000 women have come to me for breast augmentation surgery. On average, I see each woman about four times – once before her surgery and three times afterward for post-op visits.

So, 7,000 women x 2 breasts x 4 visits = 56,000. That’s not a problem that would have been on your sixth-grade math homework.

Through the years, I’ve observed every variation in breast size and shape, in breast perkiness and nipple size, and in women’s thoughts about their figure and their surgical goals.

If I could sum up what I’ve discovered in one sentence, it would be this: You shouldn’t make assumptions about who gets breast augmentation – and why.

Don’t assume that . . . 

. . . many of my patients are exotic dancers. Only about 1 percent of my patients are exotic dancers. The other 99 percent include teachers, nurses, hairstylists, construction workers, doctors, ballroom dancers, stay-at-home moms, company executives, waitresses, fitness trainers, bartenders, cheerleaders, policewomen who want to know how soon they can put their bulletproof vests back on, and women in all branches of the military who email us from Iraq and Afghanistan to set up appointments for when they are back in the United States. This is not a complete list.

. . . breast implants are just for younger women. True, the large number of breast augmentation patients are in their 20s, women who come in because they want to feel more feminine and self-confident. “It’s pretty bad when your 13-year-old sister can already wear your bra,” one woman told me.

The second largest demographic is in their 30s. Many women in this age range come in because they liked the fullness of their breasts during pregnancy and want to recapture that look. Others have lost weight and with it their breast volume.

Women 40 and older – and even in their 60s – come in for breast augmentation surgery, too. They want to look as good on the outside as they feel on the inside. They tell me they’ve been taking care of everyone else for years and now they’re ready to do something for themselves. Many have been thinking about breast augmentation for years.

. . . women get breast implants to attract attention. “Do you want to be proportional, turn heads or stop traffic?” That’s what one of my colleagues asks a prospective breast augmentation patient to see what she has in mind. I’ve tried it. Most women tell me they want their figure to be more proportional, and they want to fit better in their sweaters, bikinis and tank tops. Some comment that they wouldn’t mind turning heads now and then. Not many want to stop traffic. Ironically, some of my patients are policewomen who literally stop traffic – but they would rather not do it with their breasts.

. . . women get breast implants to make men happy. Only two women out of 6,000 have ever told me that their partner wants them to get implants. Instead, women have consistently told me that their partners love them exactly the way they are, and they are having surgery to make themselves look and feel better. So, sorry guys. Women don’t get implants to please you. That might be an outcome, but it’s not the motivation.

. . . a woman’s breasts are the same on the right and left side. Breasts are sisters, not twins. Few women have identical breasts; the difference might be slight or more obvious. Nipple position, chest diameter, the amount of breast tissue, the location of the breast on the chest wall, and how high or low a breast hangs all contribute to the appearance. With all these variables, it is no surprise that no one has identical twins.

. . . women need much guidance from me. Women know what they want. During medical training, we are taught that we should know the answers, that we are the authority. But I have discovered that women know best. My job is to listen carefully and to determine if there is a match between their goals and what I can accomplish. I believe I am an expert at figuring that out.

Will implants give me more cleavage?

By Dr. Ted

“Looking at cleavage is like looking at the sun. You can’t stare at it. It’s too risky. You get a sense of it and then you look away.” – Jerry Seinfeld

There’s long been a quest for cleavage. In Europe, as far back as the 1400s, bodices and corsets were designed to push up the breasts. Fast-forward 200 years to the court of Louis XIV of France, where necklines were lowered and cleavage was further exposed. Although it goes into hiding now and then, cleavage has mostly been in style ever since.

Screen shot 2013-01-16 at 10.44.21 AMWhen it’s visible, thanks to a low-cut top or a push-up bra, cleavage draws a lot of attention. Scientists conjecture that the attraction is primal: cleavage mimics the cleft between the buttocks, which we hide from view these days by wearing clothing and walking on two legs instead of four, as our ancestors did. As one headline writer put it, cleavage is a “weapon of mass distraction.”

No wonder that women frequently ask me if implants will give them more cleavage. In fact they won’t.

Let’s start with the facts: Cleavage, or the intermammary sulcus (the less-sexy anatomical term), is the space between your breasts. It’s defined by where the fatty portion of each breast sits in relationship to the breastbone.

Implants don’t change the space between your breasts. In fact, if a surgeon tries to give you more cleavage by loosening the inside bordersor going beyond the natural limits of your breasts, you could end up with a symmastia, also known as a uniboob.

What implants can do is give you more breast volume, which will make it easier for you to push your breasts together to accent the hollow between them. Bra manufacturers are happy to help you enhance your cleavage with a variety of bras, including click bras, air-lift bras, and liquid-lift models, which for some reason have gotten the nickname of “chicken cutlets.” But be careful. It turns out that your bra can give you a uniboob, too.