"I think the cohesive gel looks promising but they are new and need further study," says
New York plastic surgeon Darrick Antell, MD. Until that time, Antell will continue using saline implants for all of his breast augmentation surgeries. Both saline and silicone-filled implants have a silicone shell. But if the saline implants leak, deflate, or rupture, which they often do, they would release only salt water and not silicone into the body.
In 2000, there were 203,310 breast enlargement surgeries performed, making it the third most popular cosmetic surgery procedure, according to statistics from the ASAPS.
No surgery is without risks and for some women, an external vacuum bra called the BRAVA Breast Enhancement and Shaping System may suffice to help breasts increase in size, Jewell says. "This must be worn 16 hours a day for 10 weeks," Jewell says.
"It's like wearing a breast pump for that length of time," Jewell says. "The long term results are unknown."
This bra may be an answer for some women, but it is certainly not the answer, Antell says.
"Most women do not wear the bra for the time periods that they have to in order to see results and the average increase is very small - not even a cup size," he says. That's not the case with implants, where surgeons are able to increase a woman's bust line by one or more bra cup sizes.
"[The vacuum bra] is a step in the right direction, but it doesn't allow for controlling the shape of the breast, " Antell says. "People will not be satisfied and will want the real thing."
Still, "breast-enhancing pills and creams are heavily advertised in magazines and newspapers and we know they don't work. This bra works but not enough," he adds.
Some women will forever be in search of a better breast -- maybe bigger, maybe rounder, maybe perkier. But the definition of the perfect breast differs from year to year and from country to country, Antell says.
"The perfect breast in France is the size of a champagne flute and the bigger the better is the American way," he says.
The good news, Jewell adds, is that today women have many options in their quest for the perfect breast. "It's just not one size fits all type of thing."