The Wild, Kind Of Crazy History Of Boob Jobs

It’s pretty amazing when you think about it: The first medical report of a breast augmentation surgery occurred 120 years ago. That’s more than 65 years before the silicone implant was invented!

In 1895 — to put that in perspective, Grover Cleveland was President of the United States, and Oscar Wilde was hanging out in a London prison — a German-Bohemian surgeon named Vincenz Czerny documented what is believed to be the first breast-reconstruction surgery, on a 41-year-old singer who was concerned about asymmetry after having a tumor and much of the surrounding tissue removed from her left breast. As you might imagine, though, today’s medical technologies and prostheses were not available, so ol’ Vinny had to improvise.    

“Luckily, the lady had a lipoma, larger than a fist, in the right lumbar region,” Czerny wrote in a translated case report. “I decided, therefore, to use this for a reconstruction of the extirpated breast.”    

A lipoma is a fatty tumor. So, that’s right, folks: Czerny used a patient’s own fatty tumor as an implant to fill the space emptied by the removal of a different tumor. Creative, right? 

Although the tumor-transfer method of breast augmentation didn’t stick — not everyone has a convenient lipoma or two waiting to be harvested, after all — it got the gears going for surgeons and medical innovators who followed. Between the 1890s and 1960, no single technique for breast augmentation and reconstruction had staying power, largely because so many of the experimental methods — from paraffin injections to glass balls to alcohol sponges — failed miserably. Today, however, there are several medically sound options.      
Illustrated by Anna Sudit.
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Breast Implants
Breast implants are not only the most popular form of breast-augmentation surgery, they’re the most popular cosmetic surgical procedure overall, according to the American Society for Aesthetic Plastic Surgery's 2010 statistics (although that number might be surpassed soon by the Brazilian Butt Lift). However, even if you’ve decided to get implants, you have an additional decision to make: what kind.    

Silicone-gel and saline-filled implants were both introduced in the early 1960s. Although saline implants were briefly the more popular of the two in the 1990s, when there was a moratorium on silicone implants, dozens of studies disproving a causal link between silicone implants and autoimmune illnesses allowed them to return to the market in 2006 and consequently paved the way for encased silicone gel to regain its status as the more popular implant material.    

This second wind of popularity is partly due to plastic surgeons often preferring the results of silicone over that of saline.   

“I prefer silicone,” says Jessica Suber, MD, plastic and reconstructive surgeon at Southern Ohio Medical Center. “Though both will generally provide the patient with the look they are aiming for, I believe there is a more natural ‘feel’ to silicone implants. Most patients end up choosing silicone after being educated on both and getting to hold and squeeze the implants.”    

Material, however, isn’t the only decision a patient has to make.

“Breast-augmentation options have definitely increased. There is still the classic breast implant option, but even that has varied with the new ‘shaped’ implants,” Dr. Suber says, referring to devices like Allergan’s Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Gel Filled Breast Implant, which received FDA approval in 2013. “These can be a great option for someone who is looking for more breast fullness but with a very natural slope, versus the round implant.”    

Dr. Suber doesn’t rely on medical training alone for her opinions on breast implants.    

“I’m a big believer in testing out products prior to offering them to my patients, and I am happy to say I have breast implants myself,” Dr. Suber says, gladly putting to rest any notion that someone should be embarrassed about their decision to undergo this procedure. “It is definitely nice to be able to relate to my patients who are interested in or recovering from the procedure. I have been very satisfied with my decision, and highly recommend the procedure to anyone who is interested and a candidate.”      
Illustrated by Anna Sudit.
Fat Transfer
The term “breast augmentation” doesn’t refer to implants alone. Another surgical option is autologous fat transfer, or fat grafting, in which fat is removed via liposuction from one part of the body, processed, and injected into the breasts.    

Although experiments like Czerny’s show that medical professionals have been dabbling in fat transfer as a means of breast augmentation for over a century, the procedure didn’t become mainstream until very recently. In fact, in 1987, the American Society of Plastic Surgeons placed a 20-year moratorium on performing fat-grafting procedures, making implants the only augmentation option for decades.  

Today, however, it is recognized as both a low-risk procedure and an exciting alternative to implants.    

“Harvesting your own fat and having it transferred to a different area on your body can be a great option for some patients, especially those who are not interested in implants and have some excess fat on their tummy, flanks, or legs,” Dr. Suber says. “The downside, however, is that it may take several operations to reach the desired goal.”    

It’s important to note that while fat transfer is a proven, legitimate way to increase breast volume, doctors advertising stem-cell transfers for breast enlargement should be given some serious side-eye, according to the ASPS. In fact, based on a 2014 statement in the organization’s official medical journal, Plastic & Reconstructive Surgery, you’re probably just paying more for a plain old fat transfer, or a mystery mixture. 

“Without advanced cell-sorting procedures, the products used in these procedures likely contain many other types of cells besides fat-derived stem cells,” the statement says. Furthermore, “many clinics also offered plasma-rich platelet protein treatments, which they inaccurately marketed as stem-cell therapy.”      
Illustrated by Anna Sudit.
Temporary Saline Injections
Just like any elective surgery, breast augmentation is a very personal and, in many cases, very difficult decision. However, a rare but buzzed-about new technique is making the decision a little easier by showing women what they could look like post-op. No, it’s not a 3-D rendering or implants worn in your bra; it’s an injection that makes your breasts larger for just 24 hours.    

Sounds like magic, doesn’t it? But, it’s actually a safe, non-invasive, temporary medical procedure based on a tissue-expanding technique used in many types of surgeries.     

Given the name InstaBreast by Norman Rowe, MD, the board-certified plastic surgeon who claims to have invented the treatment, the breasts are essentially inflated with simple saline solution over the course of about 20 minutes. This injected saline adds volume for about a day, and as it’s safely absorbed by the body — and you pee out the extra salt water — breasts go back to their original size.     

Dr. Rowe is also working on an injection that could last two to three weeks, so women can get a better idea of what life would be like with larger breasts — or just for the fun of it. He has yet to disclose what the injection will be made of, though.    

Keep in mind, InstaBreast is not a cheap experiment. At $2,500, it’s not much less expensive than the average long-term augmentation procedure, which is about $3,700.      

Of course, it goes without saying that no one needs to get their breasts done. We've hopefully reached a point in our society at which we can all agree that boobs come in many shapes and sizes, and all are considered beautiful. That said, we also fully support any woman's right to do whatever the hell she pleases with her own body, and that everyone has their own reasons for deciding to undergo cosmetic surgery. Hopefully, this piece shed some light on breast augmentation, and provided some education and entertainment around a topic that is often considered taboo.

Want to know more about the wild-but-true history of breast implants? Check out our timeline below to get the full story of how the boob job has evolved over the last 120 years.

Illustrated by Anna Sudit.
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