By her 18th birthday, Laura Kearney realized "the girls" weren't growing -- but she pushed aside thoughts of breast implants.
For eight years, she resisted the pressures of society -- images of stars and starlets, the focus on female anatomy. "It's everywhere in your face," says Kearney, now 26. "I felt like less of a woman."
In the U.S., getting breast augmentation surgery -- breast implants for cosmetic reasons -- cost an average of $5,278 in 2011.
Most women have to pay that out of their own pockets. Insurance usually will not cover breast enlargement surgery. It will, though, cover breast implants for women who have had mastectomies due to breast cancer.
If you need further surgery later on, your health insurance may not cover that, either. Having breast implants may also affect your insurance rates later on.
In the end, Kearney finally did do it -- tossed the padded bras forever, opting for silicone breast implants. "It may seem petty to some people, but felt I needed to do something about it," she tells WebMD. "I didn't get a drastic implant, just one that suited me. I didn't want it to be, 'Look what she did.'"
The results? "I can't believe how real, how natural they look," Kearney says. "I can't even describe how happy I am."
In fact, she adds, the preparation for breast implant surgery pushed her into a healthier lifestyle. "I got into the vitamin regimen, quit smoking. It was a big opportunity for me to be a healthier person. It felt like everything was going in the right direction. It was so exciting."
It's a major step for most women, and often a positive one. Studies have shown that breast implants can help boost self-esteem, body image, and sexual satisfaction.
But studies have also pointed to the critical need for careful screening by doctors, and self-awareness among women, before breast implant surgery. Women who may have psychiatric or alcohol problems before their surgery may be at higher risk of suicide years later.
Here are realistic insights from doctors and patients about the impact of cosmetic breast implants, and how to tell in advance whether implants may help you.
Breast Implants & Body Image
Laurie Casas, MD, associate professor of surgery at Northwestern University's Feinberg School of Medicine in Chicago, is a contributing author of a textbook on breast surgery.
Nearly half her patients are like Kearney -- young women whose breasts never developed, a condition called micromastia. "She had two nipples on a flat chest," she explains. "It looked like a prepubescent boy's chest."