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Breast implants: Once is not enough
The popularity of breast-augmentation surgery is increasing, and most patients are repeat customers.

by Marc Spiegler

Recent scares about leaky breast implants and the wildfire success of the Wonderbra might lead you to believe that women have stopped surgically boosting their busts. But padding and complex support structures apparently won't do the trick for all women, according to the American Society of Plastic and Reconstructive Surgeons of Arlington Heights, Illinois. Between 1992 and 1994, the number of breast-augmentation operations tracked by the society increased 20 percent, from 32,600 to 39,200. That sharp rise pushed the torso-tweaking procedure into third place among all aesthetic operations, ranking behind only 51,100 liposuctions and 50,800 eyelid surgeries.

"Women's desire to augment their breasts didn't go away during the implant scare, and it was only partially placated by new apparel like the Wonderbra and augmenting bathing suits," explains Palo Alto plastic surgeon Jane S. Weston. She chairs the Women Plastic Surgeons' Caucus Committee of the ASPRS, a group founded specifically in reaction to what she labels "the breast-implant crisis." Not surprisingly, 97 percent of women who got implants in 1994 opted for saline implants, rather than the silicone-gel models that touched off a massive class-action suit brought by women who said their implants made them sick.

Plastic surgeons have been reaping the benefits of the silicone scare in both directions. The number of breast-implantremoval procedures soared 47 percent between 1992 and 1994, from 25,700 to 37,900. "A lot of patients were referred by their lawyers, who said they'd stand a better chance of claiming damages if they had actually undergone the procedure," says Weston. This crisis having passed, Weston predicts a drop-off in breast-implant removals, noting that today's breast-augmentation patients are no doubt much better informed about risks and procedures than in the past.

For the time being, however, women who have had breast implants removed are also among the best prospects for new implants. Once they have experienced a bust boost, most are not happy to revert to their less-than-ample natural status. In 1994, 68 percent of women who had implants removed opted to replace them right away, up from 60 percent in 1992. This means that at least two-thirds of implant procedures are currently done for repeat customers. Nine in ten getting replacements choose saline over silicone, preferring safety over quality. "Though the saline implant is perceived as being safer, it's hardly a perfect implant," says Weston. "It doesn't feel quite as natural as silicone."

This risk-averse behavior has its flip side, however. Weston has been surprised at her clients" response to rumors about experimental soybean-based implants; they've been clamoring for them. "With all the anger there was about feeling like guinea pigs for the silicone-gel implants, I asked them, 'Doesn't it bother you that it's still experimental?"' Weston says. "But they just said, 'Well, it has to be better, right?" Then again, Weston works in California. The "Baywatch" state has 13 percent of U.S. residents, but it accounted for 24 percent of U.S. breast augmentations in 1994--up from 19 percent in 1992.

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