Breasts Read online

  Dr. C, as he’s known affectionately by staff and patients, had agreed to walk me through the experience as if I were a regular patient. It was all so real, so slick and seductive, so full of metaphorical lotuses that I almost left with a new titanic rack. First, I was greeted by Katye, who genuinely fits the description of blonde bombshell. Like many of the curvy and silken-haired assistants here, she’s been either a swimsuit model or a professional cheerleader. We practically sashayed to a corner office overlooking leafy west Houston, not far from the Galleria mall. Several curvy vases accented the room’s modernist décor, suggesting shapelier times ahead.

  “Welcome to the practice!” Katye began. She told me that Dr. C has been practicing for fourteen years and “has been able to perfect the technique.” She showed me a book of before and after photos, in which (mostly) perfectly nice breasts end up looking like water balloons on a skinny rib cage. These headless torsos did, I have to admit, look much more sexed up in the after shots, since by now we’ve all been conditioned to associate big fake breasts with sex. More on that later.

  Katye walked me next door to the 3-D imaging room, where, in the name of journalism, I disrobed. After I comfortably settled into my white waffle-weave robe, she showed me implant samples. They were about the size of a large Krispy Kreme. Both the silicone and saline ones were cased in a round, clear, silicone bag. The silicone implant felt nice and soft in a detached way, like bread dough through Saran Wrap. The saline one felt like a bag of water, which is what it is. Women who wear these sometimes make sloshing noises, and ripples can show through the skin. They are less expensive, though, and may be safer if the implant ruptures. In that case, the breast deflates like a flat tire. When a silicone implant ruptures, it is supposed to stay in place since it has the viscous properties of a gummy bear. This is a vast improvement over the more syrup-like silicones of old.

  Dr. Ciaravino came in and introduced himself. He has a broad, tanned face and shoulder-length brown hair. He wore a white lab coat and a thick neck chain. I could easily see him relishing his pastimes, which, according to the office literature, include driving a Porsche and playing electric guitar. I channeled my inner Houston housewife. I told him I’d borne two children, had breast-fed for years, and after going through life as a size B, was now curious as to what life might be like as a C. He nodded sympathetically. “Let’s have a look,” he said.

  The robe came off, and Ciaravino pulled out a small tape measure. He measured me from collarbone to nipple, from nipple to under-breast fold, and from nipple to nipple, calling out numbers to Katye. He took a step back and mashed my breasts together with his hands, then squeezed each one like a club sandwich. I felt like I was awaiting the word of St. Peter. I was secretly hoping one of the world’s foremost experts on flawed breasts would be so vexed by my nice, very normal breasts that he’d tell me he had nothing to offer.

  “Well, first off,” he began, “let me say you’d be a great candidate for breast augmentation.” He assessed me some more. “Where you’re lacking a little is some upper fullness here,” he said, referring to the slope above my nipples. “You actually have a decent amount of breast tissue to begin with. We just need to give it a little boost. Silicone would really serve you best. What I would say if we were truly just trying to gain a little upper fullness and enhance its look, we would want to work with implants in a 250 to 275 cc range. This would move you into an average C size.” (Silicone implants from Mentor, for which Ciaravino is a paid consultant, come in a range of about 100 to 800 ccs, or cubic centimeters. Most women in Texas go much bigger than what he was recommending for me. “Big breasts are part of the Texas tradition,” he said. For perspective, some women test sizes by filling sandwich bags with rice: 275 cubic centimeters is the equivalent of 11/5 cups of rice; 800 cubic centimeters is almost 31/2 cups of rice.)

  Ciaravino then led me to his new $40,000 Vectra imaging machine, which would simulate how the implants would look in my breasts. He ducked out, and I, still half-naked, stood motionless in front of the small-saguaro-sized device, with its white plastic trunk and arms, while it captured me in 3-D. Katye clicked a mouse on a computer and then told me I could get dressed behind a small curtain. Soon an image of my torso popped up on her monitor, and together we watched while she punched in some magic codes. Two images appeared on the monitor, me with my real B-plus breasts and then me with big breasts getting bigger and bigger.

  “Oh my God,” I said to the screen. I was va-va-voom. But not in a good way. My breasts were big and pendulous and pointing outward. My nipples had the strabismic look of a walleye.

  Dr. C popped back into the room and looked at the monitor.

  “Oh, that’s huge,” he said.

  “I kind of have a sideways thing going on,” I said.

  “Yeah, that doesn’t look too good. I would back it up to about half of that,” he told Katye at the controls. “Keep going, keep going.” My cyber boobs were shrinking before my eyes. “Sometimes the machine distorts things,” he explained. “Your nipples won’t really go out like that.” Katye next brought up the profile images, which looked much better. Instead of my breasts having the regrettable ski slope above the nipple (something I never noticed before), now they had the curves of an upside-down cereal bowl.

  “You’ll do wonderful,” said Dr. C.

  THERE’S NOTHING LIKE AMERICA’S CONSUMER CULTURE TO convince us that what we have isn’t quite good enough. We didn’t used to be this way. Americans have traditionally been toughskinned and self-reliant. At the same time, of course, we’ve been great reinventors of the self. Hollywood may celebrate the heroes of the former, but its images reinforce the latter. In breasts, these two strains of character found a new tension by the middle of the last century. Somewhere along the line, lured by Jean Harlow and Jayne Mansfield and the technological promise of postwar America, American women tossed out the make-do-with-what-you-have mentality and embraced a burning desire for outsized nose-cones.

  Highly engineered bras helped, but only if you had something to put in them. Kleenex was popular, and so were socks. Falsies, made out of wire, sheet metal, papier-mâché, rubber, cork, elk hair, or cotton, became a multimillion-dollar industry. In its 1951 catalog, Sears offered twenty-two different versions. At that time, surgical solutions to a larger bust were dangerous and rare. Many more breast reductions were performed than breast augmentations. For much of Western history, large breasts were considered a burden and a handicap. Consider the case of poor Elisabeth Trevers, a young Englishwoman who, according to her surgeon, woke up one morning in 1669 “and attempted to turn herself in bed, [but] she was not able … Then endeavoring to sit up, the weight of the breasts fastened her to her bed; where she hath layn ever since.”

  Augmentation came later. Although inserting foreign objects into the body was known to be dangerous, there were always some surgeons and women willing to experiment. The first boob job is attributed to Vincenz Czerny, a Heidelberg physician. He transplanted a benign fatty growth from the backside of a forty-one-year-old singer to her chest in 1895. It was a good idea, since the material came from her own body and was less likely to cause an immune-system rejection, but the result was lumpy and, because the fat liquefied, temporary. That was failure number one.

  From that point on, the backstory of implants reads like a horror novel.

  In the early twentieth century, implant materials included glass balls, ivory, wood chips, peanut oil, honey, goat’s milk, and ox cartilage. What became of the (thankfully few) women who volunteered for these leaps of science? The parable of paraffin offers a glimpse. From the mid-nineteenth century, paraffin injections had been used on facial deformities. Sadly, there was plenty of opportunity; both war and syphilis—which depressed the nose—were great for advancing the art of plastic surgery. Inevitably, the wax was injected into the breast. But by 1920, its limitations were well known. It melted in the sun, for one. It also created lumps and tumors called paraffinomas that eventually had to be exc
ised out, leaving scars. Beyond that, other problems were puss, hardness, blue skin, and feverish rheumatism. At least one woman’s infected breasts had to be amputated. As one historian put, the disadvantages of paraffin ranged from aesthetic failure to death.

  Of course, women going to dangerous extremes for beauty was hardly new. For a thousand years Chinese women crippled themselves and their daughters to have tiny, deformed feet. Western women literally suffocated while wearing corsets, some of which punctured their internal organs. Women have painted their faces with lead and arsenic and ripped their body hair off with hot wax. Oh, wait, we still do that.

  Into this sorry milieu came the plastics revolution and a new breed of unholy implant contenders: Teflon, nylon, and Plexiglas. Several surgeons were moved by the shape of plastic kitchen sponges. In 1957 a Johns Hopkins surgeon implanted a polyvinyl and polyethylene sponge (also made with “foaming agents” and formaldehyde) called the Ivalon into thirty-two women. As one magazine reported at the time, “The material’s one drawback is that when it dries inside the breast it becomes a hard lump.”

  Meanwhile, toiling in a laboratory in Midland, Michigan, chemists were experimenting with different uses for a versatile material called silicone. Corning Glass Works had begun fooling around with the stretchy composite in the 1930s, making it from silicon (an element) left over from its glass production. To this they added organic carbon-based chemicals in various configurations, resulting in a material that was pretty close to miraculous: hardy, inert, and heat resistant, yet soft and flexible. It was a glass-and-plastic hybrid, with the best properties of both. The company thought it might make a good mortar for its trendy glass bricks (they were wrong, but the failed formulation found new life two decades later as Silly Putty). At the beginning of World War II, U.S. Navy officials coveted a similar formulation of silicone, finding it perfect for insulating airplane ignitions (it made long flights to Europe possible) and for lubricating machinery. To guarantee larger supplies of the carbonbased ingredients, Corning partnered with Dow Chemical in 1943 to form a new war-christened giant, Dow Corning, in the American heartland.

  When the war ended, Dow Corning was eager for new civilian markets for wartime products. The company began ardently filing patents for silicone polishes and paints, adhesives, silicone shoe rubber (astronaut Neil Armstrong would take a giant step in it in 1969), caulking, and other applications. The medical profession was intrigued by silicone’s strength, flexibility, and apparent non-reactivity, and slowly the material made its way into catheters, stents, tubing, and blood bags.

  In American-occupied Japan, another, less orthodox use was found for silicone. Drums of the stuff, needed for cooling transformers, went missing from the docks of Yokohama harbor. It turned up in the breasts of Japanese prostitutes, who were being injected with it to better attract enlisted farm boys. The technique spread through eastern Asia and became one of Japan’s most popular exports to the United States. But as with paraffin, the industrial caulk-like material was known to migrate throughout the body, form hard lumps, and cause serious infections.

  Back in Houston, plastic surgeon Thomas Cronin was holding a new silicone bag of warm blood in St. Joseph Hospital. It was 1959, and the blood bags were a nice change from glass bottles. My, he thought, that feels good. That feels like a breast.

  The era of the boob job was about to arrive.

  AT FIRST GLANCE, THIS HARD CITY OF OIL DERRICKS, PIPELINES, and banks might seem an unlikely place for such a defining moment in the natural history of breasts. But in addition to its status as the oil and gas capital of the country, Houston in the 1950s was emerging as a major medical hub, in no small part because of the city’s oil and gas wealth. MD Anderson Cancer Center had been created in 1941 as part of the University of Texas system. Houston’s Texas Medical Center, including several nonprofit hospitals and schools, was well on its way to becoming the largest medical center in the world. At Baylor College of Medicine, where Cronin worked, a cardiologist named Michael DeBakey had just pioneered a procedure called patch-graft angioplasty with a Dacron swatch, a celebrated technique still used today. Plastics and chutzpah were revolutionizing medicine.

  Add to this a lively burlesque scene, the city’s embrace of petro-fueled commerce and technology, and its particular brand of cowboy entrepreneurialism, and Houston was perfect for the Future Boob mantle. Cronin was ambitious, and he’d been thinking about the breast for some time. He was aware of the practice of silicone injections and dismissed it as no good. But when he saw the new blood bags, he reasoned that if the filler substance could be contained in a sac, many of the collateral problems would be solved. He and his chief resident, Frank Gerow, found a receptive audience at Dow Corning. Working with the company, they designed an implant using a silicone rubber bag filled with silicone gel. On the back of the bag, they added several patches of Dacron in the hope that it would bind to the chest wall and keep the sac from ending up in an armpit. Accounts vary about how they tested it. Some authors say they tested it in six dogs, but Dr. Tom Biggs, who was another resident of Cronin’s at the time, told me they tested the implant in only one. She was, he recalled, a pound mutt named Esmerelda. When Esmerelda survived the surgery, the doctors called it good. (Esmerelda was not as delighted by her new profile, however. She soon chewed the implant out.)

  Next, they needed a human volunteer.

  IN 1962, TIMMIE JEAN LINDSEY WAS A TWENTY-NINE-YEAR-OLD woman with a hard life behind her. After her mother died of cancer, she dropped out of high school at the age of fifteen, left home, and married a gas-station attendant. Six kids and twelve years later, she kicked him out for being a slouch and an alcoholic. She then fell hard in love with a steelworker, who talked her into getting a big tattoo. A red rose on her right breast said, “Fred,” one on her left breast, “Timmie,” and in between bloomed yet another rose. But Fred was a womanizer and things didn’t work out. At a checkup, Timmie Jean’s doctor audibly gasped when he saw her chest. Feeling ashamed and depressed, she went to Houston’s public hospital, Jefferson Davis, for dermabrasion. That’s where she met Cronin’s chief resident, Frank Gerow. He was another man with a plan for her breasts.

  I found Timmie Jean in a small unincorporated town east of Houston. With both Cronin and Gerow dead, she is, on the fiftieth anniversary of her historic implant surgery, the best remaining artifact of the era. Nothing in Houston commemorates the event or the hundreds of millions of dollars that breast implants would soon be pumping into the medical and legal communities. But then again, Houston is not a looking-back kind of place.

  “That’s how it all started,” said Timmie Jean, who’s now seventynine and, to my jaundiced eyes, surprisingly healthy for having been a surgical guinea pig. A robust and gracious redhead, she works the night shift at a nearby nursing home that no doubt houses a few people considerably younger than she. She welcomed me to the same house in which she has lived for the last fifty years, though the house, much like her chest, has undergone some augmentation, including a couple of small additions to the original shotgun floor plan. Tan with red shutters, it sits not far off Interstate 10, next to a boat-and-generator repair shop and across the street from two large chemical holding tanks. We sat on a couch covered with crocheted afghans in a room crowded with pictures of her children and grandchildren. A straw-hat collection decorated one wall, and in the next room, an upside-down pink umbrella served as chandelier above the dining table. Now a widow, Timmie Jean shares the house with her daughter Pamela.

  “Unbeknownst to me, implants were in development and they were looking for young women to be the first to have them,” she told me in a gravelly Texas twang. “So they brought it up to me. They asked me, would I like to be in a study to have implants? I’d never even dwelled on [my breasts]. I was okay with what I had. After six children I guess they were kind of saggy. I said, ‘You know, what I really want is to have my ears pinned back.’ My brother had teased me my whole life. They said, ‘Yeah, we’ll fix your ears too.’
”

  So in a move that would never pass today’s institutional review boards, Timmie Jean got a cosmetic surgery she didn’t want in exchange for one she did. She went from a size A or B cup to a size C. “I have to tell you,” she said, “they said it would boost my confidence, but I had plenty of confidence.” With new breasts and new ears, though, more men did notice her. But there were drawbacks. At the time, she worked in a dress factory, and as a perfect size 12, she was the in-house model. But her new breasts no longer fit into the shirtwaist dresses of the time. And within five or ten years, she said, her implants hardened and sometimes caused shooting pains in her chest. She wasn’t able to do aerobics or certain exercises because of the pain. She is self-conscious if anyone hugs her. She has also suffered from rheumatism, and has had two knees and a thumb joint replaced, but she doesn’t know if her immunesystem troubles were caused by the silicone in her body or by a life of unceasing hard work.

  Around the time of her surgery, the doctors asked her if she knew anyone else for their study, and so she recruited her sister-in-law and her sister-in-law’s sister-in-law. Over the years, like many women, they also had problems with hardness, pain, ruptures, and symptoms of illness they believed were related to the implants. Her relatives eventually joined a class-action lawsuit against Dow Corning and other makers of silicone implants. But despite her ailments, Timmie Jean never publicly complained about the implants. She even testified before Congress, on Dow Corning’s dime, that she was a healthy and pleased customer. One of her daughters went on to get implants, and so did a granddaughter.

  Natural breasts have a shelf life. So do fake ones, and it’s a lot shorter. Silicone implants, even today, last only ten to twenty years, but, amazingly, Timmie Jean is still walking around with the original specimens. She is a living museum. She knows they’ve ruptured, because she’s been screened, but she doesn’t want them removed. “I don’t want to go through that,” she said. (Surgery to remove implants, known as explantation, can be considerably more involved than the original if it requires cutting away dense scar tissue, calcifications, and hard nodules called siliconomas.) Plus, she said, “I fell on my boobs and they saved me.”