Teen-age breast augmentations on the rise:

Moms are taking their daughters for implants

by, Bill Marshall, Staff Writer

BALA CYNWYD - Fathers who think their daughters are maturing faster than kids did when they were teens may one day learn that they really are - thanks to a little help from cosmetic surgeons like Kirk Brandow.

"The last two years, I've seen more and more girls," Brandow said.

Brandow said girls under age 18 make up about 10 to 15 percent of the 120 to 150 breast augmentations the Bala Cynwyd physician does each year for about $6,500 a patient.

Often, Brandow said, the girls come to his Presidential Boulevard office with their mothers, who have rarely if ever had it done themselves.

His youngest patient was 17. While there is no official cut-off age, 15 or 16-year-old, he said, may not be developed enough to tell what, if any, augmentation may be needed.

"Although the number of breast augmentation procedures has tripled in the last six years, according to the American Society of Plastic and Reconstructive Surgeons, patients aged 17 to 19 were unheard of in his practice five years ago, said Brandow.

With younger patients, Brandow asks them to find photographs in fashion magazines of women whose bust lines they would like to emulate, then meets with them to consult.

"I'll have them come back two or three times," he said. "You know how young girls can be. One week they want to be a D cup, the next week they want to go back down to a B, the next week they want to be a C."

In the past, implants were put over the muscle. The problem with that technique is that the breasts often have an unnaturally hemispherical appearance, as if the woman is smuggling grapefruits.

Now, Brandow and others put the implant under the chest muscle.

"That's why I think this is a good operation for younger girls," he said. "They don't get the same abnormality in the breast. Over time they can nurse children or do whatever they want to do."

Brandow, 41, thinks of his craft as an art, a subject he minored in while an undergraduate at Colgate University. After five years as a general surgeon, he went to Rio do Janerio where he studied and worked under Ivo Pitanguy, an internationally-known plastic surgeon known for his work on people like Sophia Loren and, it's been rumored, more than one First Lady.

A drawback to the under-the-muscle technique is discomfort. Women may have to curtail some upper body exercise routines for several weeks as the chest muscles stretch to adapt to the implants.

That gradual loosening has an unintended side bonus for patients who want to think their increase in bust size is natural: Because it takes a month or two for the chest muscles to loosen, the breasts may seem to "grow", as if naturally, but at an accelerated rate.

There is also less sloshing, another downside to saline-filled implants, which replaced silicone implants when many women complained of health problems after they leaked. Saline lacks the human tissue-like firmness of silicone.

Brandow said some sloshing is caused by improper inflation of the implant and that whatever unavoidable sloshing there may be usually isn't heard due to the sound muffling qualities of chest muscles.

Brandow tries to make the operation as minimally invasive as possible. He has a patent pending for a wand-like device which can be snaked through an incision at the armpit or navel to the implant delivery point. It deposits the rolled up implant, which is then inflated through a small tube.

Brandow said that while silicon implants leak without ruptures via osmosis, the new saline models do not. They also have a much lower incidence of having hard capsules of scar tissue form around them, which happened to as many as 40 percent of silicon implants.

"You can't compare the implants of today with the implants of the 1960's and 1970's," he said. "These have a lifetime guarantee."

He is particular about the patients that he takes.

"I probably turn away 10 or 15 percent of the people who come to me," he said. Some have unrealistic expectations. Others are not doing it for the right reasons or are not, in his view, emotionally ready.

In general, he said, women these days prefer smaller breasts as opposed to Pamela Lee Anderson type. While he doesn't necessarily agree with the United States fixation with large breasts - the vast majority of breast surgery he performed while in Brazil was done to make breasts smaller - he has no qualms with what he does, within reason.

"As a surgeon, your obligation is to find the emotion of the person, to find their dream and make that dream come true," he said.

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