Orange County Register

COSMETIC MEDICINE

The account of “Real Housewife” Tamra Barney’s decision to downsize her breast implants struck a chord with readers and cosmetic doctors.

It was one of Wednesday’s most-read stories on OCRegister.com, and comments kept pouring in today.

Implants remain a medical technology that’s loved by some, but hated by others. Although they’re no mystery to top plastic surgeons, implants are still an experimental procedure for society overall, because we’re unsure what’s best for women both physically and socially.

In response to Barney’s tale, doctors had many comments — on the importance of fitness, alternatives to breast implants, the role of cosmetic surgery as a training method, and the phenomenon of various women seeking larger implants in mid-life, at the same age when others seek to reduce their breast size.

Here is a sampling:

“I admit that I wouldn’t have watched this show a single time if my girlfriend didn’t like to watch it now and then. However, it was quite interesting to both of us that three overweight women on the show are depending on cosmetic breast surgery as a solution to their self-esteem issues that are clearly due to a poor physical self-image as a result of excess body weight. The answer is not to continue with a lifestyle where you eat poorly and then struggle with exercises (that you hate because you are out of shape) in order to ‘burn’ off the excess calories.

“A more specific concern is that when ‘bigger’ women get breast augmentation to balance their size, if they eventually do lose the excess weight their oversized implants become somewhat grotesque, or at least disproportionate in appearance.”

— Bariatric surgeon Brian Quebbemann of Newport Beach

“Although the back and neck pain are most likely not due to the breast implants, it is not uncommon for women who had large implants placed when they were in their 20’s to have them exchanged for smaller implants and a lift after they have had a few children and are in their late 30’s or early 40’s.

“By the same token we see many women in south Florida who get larger implants in their late 30’s and 40’s. I m sure there is a significant psychosocial component to this, as the women seeking larger implants are trying to recapture some aspect of their youth — more attention when their looks are changing, perhaps divorced and now on the market again, trying to rekindle relationships etc.”

— Plastic surgeon Jason Pozner of Boca Raton, Fla.

“Standard breast reduction can be performed much more simply and with less post operative morbidity with tumescent liposuction than with standard surgical breast reduction. This is still not widely offered in the US, for reasons that escape me.”

— Dermatologist Christopher B. Zachary, head the Department of Dermatology, UCI

“Experience in cosmetic breast surgery gives plastic and reconstructive surgeons greater skills and abilities that can be applied to those women unfortunate enough to require breast cancer surgery and subsequent reconstruction. Aesthetic surgery cannot and should not be considered trivial.”

— Christopher Zachary

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