"But if the numbers are clear, the reasons behind them are not. Women have varied motives for wanting implants, which have just gotten a boost from the FDA."
The statistics of cosmetically enhanced breasts are what pop culture suggests they are – eye popping. Last year, there were 329,000 operations in the United States to rebuild, enhance, enlarge, uplift or otherwise change breasts. That made breast enhancement the No. 1 form of plastic surgery, up 55 percent from six years previous.
And there is no statistic – or prognosticator – suggesting the popularity of breast surgery is likely to abate anytime soon.
But if the numbers are clear, the reasons behind them are not. Experts offer a variety of answers, from looks to better jobs, when asked why breast enhancement is such a boom industry.
"Why do women's breasts have so much cultural power?" asks Marjorie Jolles, assistant professor in the women's studies program at Cal State Fullerton. "It's a topic that scholars devote whole careers to studying."
Sex – or at least the hint of it – clearly is part of the equation.
"Women who are 40 years old and divorced think larger implants lead to richer men," says Jason Pozner, M.D., assistant professor of surgery at the University of Miami School of Medicine. But other women want breast implants to avoid being overlooked in other areas of life. "Society rewards women for their looks," says Mary Gilly, professor of marketing at UCI's Merage School of Business. "Men can get by with money and power – Hugh Hefner doesn't get all those young girlfriends based on his looks. But women need to look good to be noticed."
Some suggest that women get breast implants to improve their self-image.
Robert Grant, president of the Allergan Medical division at Irvine-based implant maker Allergan Inc. says surveys show that women "aren't getting them to attract men, but to feel greater confidence in their femininity."
Ava Shamban, a Santa Monica dermatologist and consultant for the "Extreme Makeover" TV show says large breasts are part of society's feminine ideal, which women accept and try to achieve.
"We're supposed to look like Barbie dolls. We're supposed to have these huge breasts, waists of 22, and hips of a young man. Is that fair? No," she says.
Cal State Fullerton's Jolles takes an approach that borders on the anthropological, saying breasts are important in American culture as visible symbols of maternity and sexuality.
Not only do they function as a mother's intimate bond to their babies, they also "have a rather public side as well," Jolles says, adding that people feel entitled to "comment on" women's breasts.
And, because men's attention is a potential source of power, Jolles adds, many women – though not all – consciously or subconsciously care what their breasts look like because men care.
"Looking good means looking good to men," Jolles says.
The recent surge in breast implants comes despite cautions from the U.S. Food and Drug Administration about medical problems that implants can cause.
The FDA approved the use of more natural-feeling silicone breast implants in November 2006 for patients age 22 and up. That approval ended a 14-year moratorium during which doctors, implant manufacturers and regulators watched for any complications caused by the implants.
The agency concluded that silicone implants are probably not linked to disease but might cause problems such as chronic pain, especially when they rupture. For that reason, the FDA said patients who choose silicone implants need to have an MRI scan to look for leaks after three years and every two years after that.
Despite that extra burden, patients are now choosing silicone over saline-filled models by about 3-to-1, says Donald Altman, chief of plastic surgery at Irvine Regional Hospital and Medical Center.
The surge in implant operations was well under way even before the U.S. Food and Drug Administration lifted its moratorium on silicone implants late last year. Last year's total of implant procedures was up 23 percent from 2005.
Now the pace of breast enhancement surgeries is likely to increase, since silicone models are so popular, says Dr. Roxanne Guy, president of the American Society of Plastic Surgeons.
