A few months ago, Christie, 42, walked into a plastic surgeon’s office in Seattle with overflowing E-cup implants. After getting general anesthesia, she left about three hours later with Bs.
The information technology specialist had started to feel like the boob job she’d gotten four years ago at the urging of her then boyfriend had become an obstacle, in her career and otherwise. “I’ve made a lot of transformations with my health in the last few years, eating well and exercising with a trainer, and the inflated boobs didn’t fit inI could barely run because they were so damn heavy,” says Christie, who would rather not share her surname. Her last straw: “I was at the gym when I caught a glimpse of myself in the mirror in my tight workout clothes, and I saw how fake my breasts looked. Suddenly, I felt completely self-conscious.”
After decades of steady growth, the breast implant trend appears to be deflating. What experts refer to as “explant” procedures like Christie’s jumped by nearly 10 percent from 2010 to 2014 as augmentations fell by about 3 percent, per data from the American Society of Plastic Surgeons (ASPS). Last year, nearly 24,000 womenmost between 30 and 54kissed their fake breasts good-bye.
Over on the popular cosmetic-surgery forum realself.com, women happily share before and after photos of their diminished busts. As one commenter announced, “I am proud of me for doing something healthy for me instead of worrying about how sexy I’ll look.”
Plastic surgeons around the country are removing or shrinking implants for the very same women they once augmented. Celebs leading the less-is-more charge include Sharon Osbourne, Melissa Gilbert and Victoria Beckham, who’ve been open about having their implants taken out, along with Heidi Montag, who downsized her famously huge F-cup implants to Cs.
Fueling the trend: our culture’s focus on fitness. Many women are surprised by the maintenance implants require and are no longer willing to shoulder the resulting health issues, inconveniences and costs. Changing body ideals play a big part as well. “Surgeons are seeing a definite shift in the look many women are asking for, away from the very round, prominent ‘stripper boob’ toward something more in keeping with their natural shape,” says Daniel Mills, MD, president-elect of the American Society for Aesthetic Plastic Surgery (ASAPS). “It’s early in the trend, and not every woman is on boardI had a 50-year-old patient just yesterday who wanted to be a G-cup!but we seem to be moving away from the ‘bigger is better’ attitude.”
The Boob Job Bubble Bursts
Between 2000 and 2006, a record number of women flocked to get implants; procedures rose by 55 percent. A good many were no doubt inspired by Baywatch’s Pamela Anderson and her XXL implants, as well as Carmen “32DD” Electra, ranked by multiple men’s magazines as one of the sexiest women in the world. Meanwhile, the proliferation of porn on cable television and the mainstreaming of surgically enhanced stars like Jenna Jameson heightened our national obsession with not-found-in-nature knockers. Once the FDA approved a new kind of silicone implant in 2006, juicing an already booming market, augmentation soon surpassed liposuction as the top cosmetic procedure in the country.
Fast-forward to 2015, with a whole lot of implants starting to degenerate, and more and more women in their 30s, 40s and 50s weary of the upkeep. “Implants are not lifetime devicesthe longer a woman has them, the more likely it is that she will need additional surgery, which could include replacement or removal,” explains Janette Alexander, MD, a plastic surgery medical officer in the FDA’s division of surgical devices. That’s not exactly a fact you’ll find splashed on the plastic surgery billboards around the country. Adds Michele Manahan, MD, assistant professor of plastic and reconstructive surgery at Johns Hopkins University, “I see a significant number of women who’ve gone through one or two surgeries and just get tired of having to deal with implants.”
Disproportionately large fake breasts can cause neck, shoulder and back problems (challenges that naturally large-breasted women often have to contend with, too). “The bigger the breast implants are and the more they protrude from the body, the more they change the center of gravity, and the more force they exert on the spine,” explains Theodore Shybut, MD, an orthopedic surgeon and assistant professor at Baylor College of Medicine in Houston. That’s an issue facing many augmented women in cities like Houston, Los Angeles, Miami and Las Vegas, where epic implants still reign. Pendulous breasts can become even more problematic after menopause, as many women gain weight in their breasts (and elsewhere) on account of hormonal changes.
No matter what size a woman gets, rupture or deflation occurs in roughly 10 to 25 percent of silicone gel and saline implants over 10 years, manufacturer studies reveal. (Saline implants consist of a silicone shell filled with sterilized salt water; they’re less commonly used these days than those containing silicone gel.) Capsular contracturestiffening of scar tissue that can lead to pain and rock-hard, misshapen breastshappens in 18 to 19 percent of both types of implants over 10 years. “Placing implants beneath the chest muscle, as most surgeons do today, versus on topmore common in past yearsgreatly lowers the risk of contracture,” says Dr. Mills. That doesn’t help women who got their breasts done years ago, many of whom are now suffering the consequences.
Some insurance policies pay for revision or reduction surgeries for women who develop serious complications that limit their ability to work or simply move around. But others deem cosmetic breast implants elective and won’t cover fixesor screenings for ruptures. (Insurance companies and HMOs that cover mastectomies for breast cancer must, by law, also pay for reconstruction.) That out-of-pocket cost is motivating many women to ditch their implants. As Aimee, a 32-year-old mom and accounts payable clerk in New Orleans (who also asked that her last name not be used), says of her recent removal, “I just couldn’t see myself spending a few thousand dollars to update my implants each time. I didn’t want to deny my son and any future children summer vacation because Mommy had to get her boobs done.”
Size Really Does Matter
For many of us, fitness is everything. But excessively large implants can make jogging uncomfortable and upper body toning moves difficult, notes Dr. Manahan. Fed up with being weighed down by her falsiesand needing to replace them anywayDana McCoy, a 31-year-old fitness instructor in Newport Beach, Calif., went under the knife earlier this year to trade her D cups for As. “I was unable to do an unmodified push-up without feeling like my boobs were about to explode,” she says.
Women may also be responding to a new cultural norm. Being super fit is now considered the epitome of beauty, just as being waifish or having a pear shape once was, notes sociologist Victoria Pitts-Taylor, PhD, chair of the feminist, gender and sexuality studies program at Wesleyan University in Middletown, Conn. “Cultural preferences for body shapes move in and out of vogue,” she says. “Renaissance painters showed women with the plump, round bodies and small breasts that were ‘in’ then. Pop art and fashion in the 1960s were all about thin, flat-chested Twiggy types.” Then came the porn-influenced emphasis on big boobs and a tiny waist in the 1990s and early 2000s, “a tough look to achieve without plastic surgery,” adds Pitts-Taylor.