Which Breasts Are Best?

Let's go back to the question of breasts today– and get over it! This month's Jane magazine polled 600 adult women about their breasts: 74% of those surveyed said they were dissatisfied with the shape and size of their own breasts. Let's get this fixed.



























No, Jessica Simpson is not the real thing nor should any woman compare herself to silicone-enhanced breasts. It's like comparing apples and oranges. They're not the same fruit. But just to convince you, let's walk through how the all-seeing eye-of-Anne knows when those ta-tas are altered.

What gives away breast implants? Capsules, growth spurts, ripples, tunnel cleavage, adhesions, rimming, hardness, distortion, disproportion, immobility, scars, supernatural suspension. Shall we illustrate this?

Here's a candid picture of the original equipment from early in her career. Jessica Simpson's breast appear to be a small C-cup, her father's groping comments aside. She's 18 or so in this picture, about the time when breast growth is complete (pregnancy-related changes excluded). In the last eight years, however, Jessica Simpson has had some unusual growth spurts...and even more unusual circumscribed 'weight loss'...all in her breasts. They've been in, they've been out, they've been in again. Currently they appear to be out. Cue the music— "Thanks for the Many Mammaries." Does any of it make her look more or less beautiful? You decide.

In 1992 the FDA effectively took silicone breast implants off the cosmetic market and only recently re-approved them for elective augmentation surgery. Last November the FDA lifted its 14 year near-ban on silicone gel implants. None of this slowed down the current wild popularity of bigger bazooms through plastic surgery.

The viscosity of the filling material is what distinguishes the feel of the augmented breast, since all implants use silicone outer shells. Saline implants are round and filled with simple salt water. Most of what you see on inflated chests is in fact saline-filled and a poor substitute for real mammary tissue. These surgically implanted sacs can feel akin to a waterbed—especially during physical activity. Silicone implants, by contrast, are filled with a synthetic gel, a consistency not unlike a weak squeeze ball. Silicone gel also comes in a variety of shapes and conforms more closely with the natural tear-drop shape of real breasts. Saline implants have a round, balloon-ish quality and are much easier to spot with a quick glance.

A lot of women opt for subglandular placement (under the mammary tissue, over the pectoral muscle). The advantages? It can postpone a breast lift (mastopexy), by adding volume to counter mild sag (ptosis), but this is temporary. Keep in mind that the only thing supporting the implant is the elastic integrity of the skin and breast tissue.

Paula Abdul shows the perils of too much, too late. A subglandular placement requires less recovery time with less post-op discomfort, since the muscles are left intact. Actresses and strippers also prefer it for the enhanced projection. Conversely, a very large implant placed sub-muscular (without tissue expansion which is what post-mastectomy patients undergo) is agony. But it looks more natural.

Other disadvantages to a subglandular placement? Ripples and adhesions. As the implant drops, or settles into place, the surface of the shell can pull on the scar capsule, which in turn pulls on the skin. This produces traction rippling ala Beyonce.

A lot of surgeons operate through incisions you might not guess. The trendiest is transumbilical (TUBA), an approach through a naval incision. Transaxillary (armpit incision) is also popular. An incision hidden in the inframmamary fold (crease under the breast) or peri-areolar are the most common and can give truth to the lie. It also often impairs nipple sensation. Poor Tara Reid.

Placement of the breast implant over the pectoral muscle (subglandular) is very obvious in thin women with little natural breast tissue. The highly technical description is generally "bolt-on breasts." In Hollywood you really can be too rich and too thin. Just Victoria Beckham.

The most common cause of an unnatural appearance? Capsular contracture occurs when the scar tissue that naturally forms around the implant tightens and squeezes the implant into a hard, unnatural appearance. The previous older generation of silicone breast implants were particularly prone to this. No surgeon can completely control for the vagaries of healing and this has caused many stars, from Demi Moore to Courtney Love, to undergo multiple breast operations.

And most tellingly, when you squeeze on a breast– say with a tight bodice– the outline of any subglandular implant becomes more obvious, particularly in thinner, Hollywood-type women. The demarcation of the upper rim of the implant is a dead giveaway. It doesn't happen in nature.

Real, voluminous breasts look like Scarlett Johansson's "girls" in a fitted gown: pillowy with no tunnels in sight.


Hear Anne live on the Kevyn Burger show Thursdays featuring Knifestyles of the Rich & Famous.