But surgery's not for me: After growing up in Los Angeles, I'm permanently scarred from seeing too many augmented playmates with top-heavy silhouettes that fit better in Juicy Couture than my tailored Helmut Lang. And while implants typically create three-cup-size increases (C is the most popular cup size for patients under age 35), Macrolane only gives a one-cup boost that lasts for 12 to 18 months before it's safely absorbed by the body (though your bust can start deflating after nine months).
"My Macrolane patients don't want the look of an implant," says Inglefield. "If it wasn't for this filler, these women wouldn't get any augmentation; they'd just continue to wear gel bras for the rest of their lives." But ditching the padding isn't cheap. Inglefield's bill is £3100, or about $6000 (not including flight and hotel), which is expensive considering that the average surgeon's fee for implants in the States was just above $3800 in 2007, according to the ASPS. (D'Amico estimates an average total cost, including anesthesia and operating-room fees, of $7000 to $10,000 in the New York area.)
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.