Medicine: Building up Bosoms

In the opinion of physicians, most of whom are men, micromastia (abnormal smallness of the breasts) is neither a very serious nor a very common complaint, but a great many U.S. women seem agitated about it, some to the point of severe neurosis. In San Francisco last week, the American Society of Plastic and Reconstructive Surgery was divided over the desirability of a drastic remedy: surgery to pad out the breasts, using either body fat or a spongelike synthetic.

Manhattan’s Dr. Gustave Aufricht, 63, was amused by what he regards as a current fad for big breasts, because in the early days of his practice, in the 1920s, an equally common problem was the reverse—how to reduce large breasts.* Now, to make bosoms bigger, he uses fat taken from the woman’s own body (usually the buttocks, which many women are glad to have reduced anyway). Dr. Aufricht and his colleagues at Manhattan’s Lenox Hill Hospital will have nothing to do with a patient who shows signs of emotional disturbance.

In sharp disagreement was Johns Hopkins University’s Dr. Milton Edgerton, 36. He reported that in three years he has operated on 32 women, aged 28 to 38. All were married, and all were emotionally upset by what Dr. Edgerton called “a local anatomical fixation” on their small breasts, though he had them screened by a psychiatrist to be sure that none had more deep-seated mental illnesses (an equal number were turned away on this score). Instead of natural fat, Dr. Edgerton used a form of built-in falsies made of a poly vinyl sponge called Ivalon. Checked by psychiatrists after their operations, all patients showed a reduction in their feelings of “inadequacy” and “depression,” though one insisted on wearing outer falsies as well. Two later nursed their babies with no trouble.

Main objection among the surgeons to this type of operation is that the Ivalon does not stay spongy, but shrinks 20% and becomes as hard as a baseball. Dr. Edgerton admitted this defect (he is careful to warn his patients of it in advance), but felt that the operation was still justified because “it is important to do something for the patient emotionally.” About 30 of the 500 surgeons at the San Francisco meeting said they perform this operation; some have abandoned it because they got poor results, had to remove the polyvinyl in a second operation.

On one point the flesh sculptors were unanimous: what plastic surgery needs is a spongelike substance that will stay soft indefinitely. A majority held that the current concern over micromastia is really a mass micromania—a “culturally induced” delusion of smallness.

* In this era of the “roll-of-oilcloth” figure, high fashion decreed bosom-flattening brassières.