Story originally appeared in BND’s Lipstik Magazine in 2009.

Flat. Droopy. Socks full of rocks.

However you refer to yours, chances are you’re one of the millions of women who are unsatisfied with their breast size or shape. And if you’re not, you’ve surely eavesdropped in on a fitting room conversation, particularly during swimsuit season, and heard the complaints.

“Ugh…this top needs more padding” or “Hey, if I put those chicken cutlet things in here, do you think they’ll float out when I get in the pool?”

Dr. Bruce Bryan, an OBGYN in Brentwood, says that many of his patients are unhappy with their breasts, particularly after pregnancy.

“During pregnancy, breast size increases fairly quickly, then shrinks back down after losing the weight,” says Dr. Bryan. “The tissue loses its elasticity and often never returns to its original size or firmness.”

Some women simply never grow to a size that makes them feel acceptable compared to hubba-hubba models in lingerie magazines, and perfectly proportionate department store mannequins. And then there are those who used to have them and, through aging or weight loss, have lost them.

braSo if you’re completely distraught over imperfect breasts, what are your choices? You can continue to buy $50+ ultra-padded bras from Victoria’s Secret, and keep your teeny weeny secret under wraps – and clothing, or you can do something more permanent.

Surgery

When you think of fake boobs, it’s hard not to picture the cantaloupe look for which Pamela Anderson has made herself so famous. But most women simply want to look natural or have what they had before kids, or before gravity took hold.

Michelle Smith* liked her breasts before giving birth to and nursing her two children.

“Afterward, they turned into these saggy, deflated sacks of skin,” said Smith. “I lost a lot of my confidence and was self-conscious, even in front of my husband.”

Smith chose augmentation to lift and restore her breasts, and is completely satisfied with the results.

“I feel even better than I did before I had kids,” she said. “It’s fun to buy clothes, nice to feel sexy again, and overall it has just built me up.”

If you ‘re interested in surgery, Dr. Bryan says it’s vital to choose a surgeon who is certified by the American Board of Plastic Surgery, since this certification requires extensive specialized medical training and experience.

Some surgeons provide a free initial consultation while some charge about $100. During this visit, the doctor will discuss family medical history, such as any occurrences of breast cancer, Lupus, or connective tissue problems. He’ll want to know if you plan to lose weight or become pregnant, since these can alter the results of your implants. He’ll also take measurements and make recommendations regarding incision locations and types of implants.

Saline implants are filled with sterile saltwater. If a saline implant deflates (a 1% chance), the surrounding tissue absorbs the saltwater, so they’re considered the safest option. And since saline-filled implants are inserted before they’re filled, they can be placed with an endoscope through a tiny incision in the armpit or belly-button, around the areola, or near the fold of the breast.

The FDA banned silicone implants in 1992 after many had been rupturing. Since the body doesn’t absorb silicone, some women were becoming very ill. But in 2006, after years of research and test studies, manufacturers showed evidence that only 1.4% of patients in a 3-year-period had breakage, and that the implants last for at least ten years. They were allowed back on the market, and some surgeons prefer them today, claiming their texture more closely duplicates breast tissue. But because silicone implants are pre-filled, the incision has to be larger, and is usually made in the fold of the breast.

Besides choosing the type of implants, you’ll need to decide if you want them placed above or below the pectoral muscle. Going under the muscle can make you look more natural – reducing that “stuck on” look, especially if you don’t have much tissue to cover the implants. This also puts the implants further from breast tissue, causing fewer problems with detection of breast disease in MRIs. There also may be less nipple numbness if the implants are placed farther away from the nipples. Doctors usually recommend this type of placement for women with an original breast size of ‘B’ or less.

If you’re happy with your size, but you want to be higher and rounder with lots of cleavage (think Tori Spelling), implants can go over the muscle. A disadvantage to these is that if you don’t have much breast tissue to cover them, you may be able to feel the implants, or even see a “rippling” effect when you move.

Potential Problems

While filling out your bikini by next summer is exciting, don’t give up your seat on the Itty Bitty Tittie Committee just yet.  Augmentation is a major surgery that requires recovery time and poses several risks.

Most surgeries are outpatient, and if all goes well, post-surgery pain will last only four or five days. In a best-case scenario, you can return to work in about a week, and to be back to normal everyday tasks (lifting, jogging, etc.) in about four weeks. Implants are fully “settled” within a year.

But here’s the kicker. There’s a five percent chance that an implant could rupture and cause infection. If this happens, the implant has to be removed, and re-inserted six weeks later.  Implants can also move out of position at any time, form scar tissue around them, or deflate, all of which could require more surgery, meaning more time away from work.

Implants pose a 1% chance of infection, usually occurring within two months of surgery. The infection can be treated with antibiotics and the implant can be removed, but you’ll have to wait six months to get a replacement. That’s a long time to have two very different sized breasts.

No surgeon can guarantee that you won’t have nipple numbness. Almost 15% of patients complain about this, so if the thought bothers you, you may want to reconsider.

If you plan to become pregnant, it’s probably best to wait for breast surgery.  Although surgeons have different opinions as to whether or not the look of implants will change after childbirth, Dr. Bryan says that in his experience, women with implants usually choose to have further breast surgery after giving birth.

“The skin tissue around the implant still stretches throughout pregnancy, and it depends on your skin type whether or not it tightens or sags after that extra weight is lost,” says Dr. Bryan.

It’s possible to breastfeed with implants, but Dr. Bryan has had patients who have had trouble with milk production, and one patient who had to stop nursing after getting an infection caused by her implant.

The Cost

You can expect to spend about $6,000 on a new pair of boobs. Most surgeons charge about $3,500 for the implants and placement, but that doesn’t include anesthesiology, facility fees, and pre- and post-operative care. Many cosmetic centers offer financing, with a minimum down payment required, and then a monthly payment as low as $139 per month. Insurance companies don’t usually cover the cost of elective cosmetic surgeries, except in cases of reconstruction due to a mastectomy, or reduction due to back and neck pain from larger breasts. You should be aware that if complications arise, your insurance company will probably not cover treatment costs, and some will no longer cover any treatment relating to the breasts of a woman with implants.

Non-Surgical Options

There are a couple of all-natural alternatives that can or at least claim to enhance breast size and position. Herbal treatments such as Perfect Curves supposedly stimulate a woman’s body to produce hormones which cause the body to deposit fatty breast tissue in the breasts.  This fatty tissue, called “adipose,” is suspended in connective fibers extending from the muscles of the chest to the underside of the breast skin.  According to the company, the pills and creams increase the fatty breast tissue and strengthen the connective tissue, causing the breasts to become larger AND firmer. They say that this process doesn’t cause any weight gain, but Dr. Bryan said he wouldn’t put much faith in that promise.

“When you’re altering hormone levels, such as those increased during pregnancy and menstrual periods, it’s nearly impossible not to gain some weight,” said Dr. Bryan.

So if you’re prepared for a little extra junk in your trunk, you could increase your bust by 1-3 cup sizes in 90 days for under $250. With a 90-day money-back guarantee, it couldn’t hurt to try it.

You can also try to change your breasts naturally with simple exercises. Dr. Anna Dyer of Livestrong.com claims that chest exercises such as flies and plank-poses can lift sagging breasts. Chest flies can be done at home with light weights, or in a gym with a fly machine. She recommends performing two to three sets of 10 to 15 lifts. A plank-pose is similar to a push-up, but instead of lowering your body toward the floor, you’ll hold your arms out straight for 10 to 15 seconds, eventually increasing to 30 seconds and repeating several sets.

 Making a Decision

Yes, men are obsessed with breasts, but we women are just as guilty of staring when a nice set passes by. Having them could make you more confident, improve your sex life, and allow you to fill out some really cute tops. If you’ve done your research, accept the risks, and can afford them, go for it. You could be the next babe getting googly eyes from all your envious friends.

But if you don’t have the money or simply want to play it safe, you may need to accept or at least work with what you have.  It might help to take a closer look at the advantages of having little boobs. It IS easier to go for a run without having to strap on three sports bras. Plus, you’d hate to part with all those push-up bras you’ve already paid for.

And consider this next summer when you’re playing with your kids in the backyard, and your voluptuous neighbor comes out in her tube top to water her flowers: Yes, she looks fabulous, but could she have as much fun as you can flopping down on that Slip-N-Slide? I think not.

*Name has been changed for privacy.