Cost aside, my other concern involves another C word: cancer. "Any time you add something in the breast area, it can look like a tumor on a mammogram, so you can misdiagnose," explains Dallas plastic surgeon Dr. Rod Rohrich. "We have over 40 years of safety data for implants — I would prefer to see 10 years of data before I recommend Macrolane." But in the age of lunchtime Botox, a temporary filler still seems safer than surgery. Since I have no family history of breast cancer, am under 30, and won't even be getting my first mammogram for a while, I decide I'm in the clear.
I choose Inglefield as my doctor because he's been at it the longest in the U.K.; he's used the filler since October 2007 and performs six to seven procedures a week, with a very low complication rate (less than 0.5 percent for bleeding or infection; less than 3 percent for scarring). To further ease my mind, he gives me the name of a New York plastic surgeon whom I can see if I have any issues. Inglefield also stresses the importance of after-care: "It takes five to seven days for the breast tissue to stabilize the product so it doesn't shift around." Exercising or doing any rigorous activity too early can move the gel, causing lumps (which must then be treated with massage or, in more serious cases, by injecting the enzyme hyaluronidase, which breaks down the hyaluronic acid immediately). With my mom by my side, I'm ready.
The afternoon of my appointment, I'm woozy from the antibiotic-painkiller cocktail the doctor had prescribed. As I close my eyes and lie back on the treatment table, Inglefield injects the local anesthesia into my right breast using an instrument the size of a knitting needle. The pain is brutal. I can feel every push and prod, especially under the nipple, which feels like it's being sawed off. "Your muscles are very tight, so it's hard to push the needle in," says Inglefield, between stabs. "If you were older or had sagging skin from breast-feeding, this wouldn't be as hard." On a pain scale from one to 10, with one being a blood-test prick, I'd give this a solid seven. But after 15 minutes, the numbness kicks in and I relax, slurring my words when the doctor asks how I'm feeling.
Laced with epinephrine, the anesthesia makes me involuntarily twitch, like a drug addict. The doctor assures me that the spasms won't affect my results and switches to an equally enormous 12-gauge cannula to inject the 100 ccs (about one cup size) of Macrolane into my left breast and a little bit more into my right. This is the maximum amount of filler my elastic skin can take — any more and the tight tissue could push the extra gel out of the injection site. Again, I feel pressure, but this time, no pain. Inglefield sculpts as a hobby, and I feel like a lump of clay when he massages the gel into place. Another five minutes pass (the total treatment time is just under an hour). Then he asks me to sit up. After checking that my chest looks balanced, Inglefield declares me done.