While society continues to ride the rise and rise of the bigger-the-better-butt phenomenon (and partly as a counterculture reaction), a new Hollywood cleavage is about to drop: the subtle boob job.
Historically, “subtle” and “boob job” would not want to be associated with each other. And not only in this town: The FDA reports 5 million to 10 million women worldwide have breast implants, and most of these surgeries are performed in California, Nevada, Florida and Brazil. “Before the economic downturn of 2007 and ’08, women wanted full D cups,” says Beverly Hills plastic surgeon Gabriel Chiu, who specializes in breast lifts and augmentation. “They’d go up three sizes — now they’re going up one to two, max. Tacky is no longer aspirational.”
Beverly Hills plastic surgeon Rady Rahban concurs about the downsizing trend, citing the big-booty worship that has swept the globe. “Breasts are no longer at the top of the body-part desire list, having been replaced by butts,” he says. “Plus there’s the medical aspect: If a woman asked for megasized mammaries in the ‘80s, by the ‘90s she probably experienced some rippling, loss of sensation and bottoming out (where the implant slides below the nipple). So the shrinking is a reaction to both trend and lessons learned.”
It always has stood that the bigger the implant, the greater the risk of problems. “Over 350 cubic centimeters of filler means there’s double the risk,” advises plastic surgeon Lawrence Koplin. A rep for one of the big implant manufacturers (which include Allergan, Mentor Worldwide and Sientra), who requested anonymity because of corporate restrictions, confirms the peak popular breast size has diminished: “We’re selling — and therefore making — more implants in the 200-to-300 cubic centimeter range. The new ones called ‘gummy bears’ are the most requested.”
Uh, gummy bears? Not exactly an object associated with desirable curves. But there’s a lot to love about the new guys: Unlike saline (prone to leaking) or smooth silicone implants (prone to shifting), so-called gummies are filled with cohesive gel and keep their encasing sheath. They also have a more natural shape.
Dr. Lisa Cassileth, who specializes in breast reconstruction, puts it in layman’s terms: “We were never supposed to have half-melons for breasts — you look like an old lady when they start to sag. Luckily the tide has changed: A full C is considered the cap, and a B is the most requested. Many of the women who got D’s are now downsizing, particularly those who have had kids. They’re having buyer’s remorse.” And most buyers are not informed that breast implants should be replaced every 20 years. “Do you really want to be doing that surgery when you’re 70?!” asks Cassileth.
Another encouraging breakthrough is that the “lollipop lift” (a breast lift that results in an anchor scar running from under the breast to the nipple, most popular among moms over 40) also is headed toward extinction. Lifts historically have required at least a small implant to raise the tops of gravity-affected glands. Not anymore, and they no longer require scarring either as surgeons perform lifts via fat grafting. “It doesn’t require general anesthesia, downtime, scars or cutting,” says Koplin, one of the first plastic surgeons to embrace fat transfer for volumizing both the face and body. “You can go up an entire size with one session of fat transfer. The only problem is that a lot of girls in L.A. don’t have enough fat to take out and put back in!”
“Nothing’s worse than a big, saggy breast with a scar,” says Cassileth bluntly. “But you can’t make grafting look fake. It’s so natural — 100 percent natural. I even do fat transfer on my breast-reconstruction patients. And best of all, fat grafting does not cause cancer.” This procedure eliminates the need for older moms to get implants, a fact bound to be embraced by many.
“Nothing looks as weird as a 49-year-old mom whose breasts went up two sizes,” jokes a Hollywood mother who had a lift accompanied by implants. “If you think the other moms at school don’t notice that, you’re wrong. One asked me if I was taking up pole dancing.” She promptly had the implants removed and underwent fat grafting to raise her breasts to nearly the level of a 30-year-old’s. “The implant scar will never go away,” she says with a sigh. “But at least I don’t look like a hooker.”
“The reality is this,” claims Rahban: “Physicians have been the ones to blame. They wouldn’t advise women that outsizing was a bad idea — they wanted the money, or they were lazy. Now, after a few decades, women have heard the horror stories. You don’t see A-list actresses with giant boobs anymore, do you?”
Better to leave those to Bond girls. But wait a minute: Even Bond girls don’t have them anymore!
This story first appeared in the 2015 Women in Entertainment issue of The Hollywood Reporter magazine.