Recently RealSelf Trends published an article “Smaller Breasts Are In – Particularly For Women After Menopause” which has gotten me thinking. I guess the question is do women really desire smaller breasts as they go through life? While it would be attractive to come up with a simple answer, I think that the choice of breast implant size is a bit more complex.
Let me start by saying that I do a lot of revisional breast surgery. This can involve replacing breast implants with larger implants, smaller implants, or no implants, sometimes in conjunction with a breast lift. And I think it is fair to say that older women (do not ask me to define “older”) typically will want the same size or smaller implants. Younger women, on the other hand, frequently want larger implants.
One of the trends that we are seeing is that younger women initially undergoing breast augmentation are using larger implants than they did 10 or 20 years ago.
I have discussed this many times with my implant reps and they are noticing this too. Twenty years ago a 240 or 280 cc implant was the middle of the road. Now, I would say that the average is around 400 cc’s and for many women this looks proportional. Certainly I see some patients going bigger than I would like, but even with these folks aside, women as a whole are choosing larger implants for their initial surgery. This may reflect a societal change in what is attractive.
So, what has happened that makes many older women want smaller implants? This, I think, is a result of two factors.
- Women want different looks for different phases of their lives.
- Women’s bodies can change as they go through life.
Let’s address the first. What may have looked great in a bikini in the 20’s, 30’s, or 40’s may not be what a women wants in her 50’s and 60’s. This should surprise no one. We all have had changes in how we wanted to look as our lives have gone on. (Anyone remember leisure suits?) Wanting to dress and look more conservative as we age is pretty normal. So, as a generalization it is probably safe to say that younger women tend to want larger implants than older women.
On the other hand, there is a group of women whom I see that received larger implants than they wanted.
They are unhappy with their look and uncomfortable due to the weight of the implants. Usually they will have a breast lift (which they probably should have had in the first place) and smaller implants. Regardless of their age, these women want smaller breast implants.
The other inescapable truth is that women’s bodies do change as they go through life, probably more than men’s.
Frequently this has to do with the results of pregnancy, but I do think menopause plays a role to an extent. Weight gain in the truncal region can be an issue. This can increase the breast size to the point that breast implants that were previously placed become either too big or unneeded. So, yes, smaller implants for some of these folks can definitely be the way to go.
There are many “older” women who are seeking larger breasts for the first time.
Let me muddy the water a bit by saying that I have done initial breast augmentations more than a few times in women over the age of 60, and a lot over the age of 50. In these cases, menopause would not seem to be an influence. The range of implants they choose can be quite variable.
It’s important that women realize that they can modify the shape and size of their breasts if they want to. But, don’t get me wrong- we should not view such changes in the same way we would look at putting on a different blouse, or getting a different hair style. Changes in the shape of the body will usually require surgery and should be undertaken carefully.
The fact remains that what worked in the days after college, may not be right for the days before retirement.
The goal, however, would be to start with a reasonable size that fits a woman’s body, and maintain this shape and size over a lifetime. And for many, this is exactly what happens.
All the best,
David B. Reath, MD
PS: Have you seen the animated video our office staff produced?
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