Sunday, September 1, 2013

The 'has she or hasn't she' boob job: 10,000 Britons had breast implants fitted last year - but for most women you'd never know it

Au naturelle: Victoria Beckham is thought to have chosen teardrop-shaped implants for her second operation
Au naturelle: Victoria Beckham is thought to have chosen teardrop-shaped implants for her second operation



Evolutionary theorists call them ‘sexual ornaments’. According to  academics, the human female bosom is unique among primates. While ape species have large breasts only during lactation, the same isn’t true for us.
And as they remain after menopause, they are not an indicator of fertility. So, look away now feminists... the way they look mainly serves to attract a mate.
Thus, women have always drawn attention to their busts with padding, corsetry, or simply by going topless.
Today, the boob job is the most commonly performed cosmetic surgery, with more than 10,000 British women having one last year.
And as The Mail on Sunday reported last week, one in ten patients now opts for a ‘super boob job,’ increasing their bust by four or more cup sizes in a single operation.
However, many women still want a more discreet option dubbed the ‘has she or hasn’t she’ boob job.
Miles Berry, a plastic surgeon and co-author of the Good Boob Bible, says: ‘Victoria Beckham epitomises the new trend.
'She has never admitted to surgery, but pictures show  her breasts are incredibly supple and full – better than in her youth.’
Despite technological and surgical advances, there are still pitfalls when trying to choose the perfect pair. Here, experts advise how to get it just right.
IGNORE CUP SIZE
Size is dictated by the volume of the implant and measured in cubic centimetres (a 151cc to 250cc implant will give around a one to two-cup size increase). If you are looking for a natural-looking boob job, consultant plastic surgeon Patrick Mallucci  recommends forgetting about cup size altogether.
‘Don’t come in saying, “I am a B and I’d like to be a DD”. Cup size is highly subjective. I might see 20 women measuring 34C, all with completely different breasts,’ he explains. Ultimately you want a breast which is in proportion and the right implant that will achieve that.
THE PERFECT SHAPE
In 2011, Mallucci analysed the mathematical factors of attractive breasts, using 100 Page 3 models, all of whom had real breasts, as research material.
The resulting formula revealed a template for both surgeons and women considering surgery: 45 per cent of breast volume is above the nipple; the nipple points upwards at an average angle of 20 degrees; the upper half is either straight or concave, and the lower half a neat, full curve.


Victoria Beckham at the Brit Awards, London, 1997
Victoria Beckham's old implants in 2007
Back in the days: There was no mistaking that Victoria Beckham had a boob job eight years ago, but later had her 'chest oranges', right, swapped for a more natural looking implant

Mallucci says: ‘The dimensions are a template, whether you are simply enlarging or lifting as well.’
That said, the desire is normally to have bigger breasts. If you want a natural-looking boob job which is aesthetically ideal, there are limitations depending on your frame and anatomy. ‘The surgeon ought to measure the width of your breast to select the implant size,’ he says.
Too big a width means the implant shows on top of the rib cage. ‘As long as you stick to this rule you are close to achieving the perfect shape. Too large will never look natural.’
PROJECT YOURSELF
‘Projection, or pertness, of the breasts is down to the shape of the implant itself,’ says consultant plastic surgeon Fazel Fatah. ‘There are different silhouettes – low, medium, high or extra-high.’
‘The patient’s physiology must be taken into account. A 20-year-old with a flat chest couldn’t have an extra high projection as the skin would be too stretched,’ Fatah adds.
‘Under-filling is equally disastrous as it will make the skin sag around the implant,’ says Mallucci. ‘Post-pregnancy, you may have a deflated breast. The more skin laxity, the more projection is necessary.’
Another important consideration is breast tissue and skin quality. ‘Older or post-pregnancy skin  may be very thin,’ says Mallucci. ‘You don’t want the implant to  show underneath.’
ROUNDING UP
A round shape accounts for 82 per cent of implants in Britain. The other option is a teardrop-shaped implant. Fazel Fatah explains: ‘The round implant looks fuller at the top, while the teardrop slopes downwards like a natural breast.
‘Not many people have the teardrop because the surgical technique has to be very precise to avoid the implant rotating within the breast. It takes longer in theatre and the implant itself costs more, so the option is more expensive.’
There can be a £1,000 difference.
Popular op: More than 10,000 British women had plastic surgery on their chest last year
Popular op: More than 10,000 British women had plastic surgery on their chest last year

TRY BEFORE YOU BUY
Some surgeons offer 3D imaging, but usually surgeons suggest ‘trying out’ new breasts by wearing a larger bra filled with an implant. ‘British women want fullness at the top, or the Wonder-Bra effect,’ says Mallucci. ‘But if the breasts stay that shape when naked, they’ll look a bit weird. This means limiting volume in the upper bust. You can still wear an enhancing bra afterwards.’
SAFETY FIRST
‘Women should be as informed as possible about exactly what goes into their bodies,’ says consultant plastic and reconstructive surgeon Michael Cadier. The most important factor is not the type of implant, but the safety record. European legislation isn’t particularly stringent, but the US regulator, the Food and Drug Administration (FDA), has approved five brands of implant.
‘Should your surgeon not suggest one with FDA approval then there ought to be good safety data demonstrated in the form of long-term clinical follow-ups of a minimum of five years, looking at the integrity of the implant and effects on the body,’ says Berry.
A BOOB JOB IS FOR LIFE
‘The body forms scar tissue around the implant. This fibrous bag usually starts to contract after a decade, and the breast may look unnatural. If it becomes unevenly shaped it may have ruptured,’ says Berry.
However, as long as you have a decent implant there are no serious concerns should this happen. ‘Women often only find out about rupture when they go for a mammogram at 50,’ he adds. Once you know they’re broken, they ought to be removed.
Many women need reductions too. ‘This is why a size eight woman wanting to have massive breasts is going to be in trouble,’ says Fatah. ‘The breast tissue will be very thin and when they are replaced she may be left with sagging breasts.’
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