Double trouble: Are breast enlargements imitation or mutilation?

Big, bouncy and completely fake, larger-than-life bosoms are everywhere we look. Is it any wonder that last year, 26,000 British women went under the knife? More's the pity, argues Bethan Cole – you can't improve on nature

I remember distinctly the first time I saw a pair of surgically enhanced breasts with my own eyes. It was around eight or nine years ago, in the changing rooms of the gym at a private members' club where a friend had taken me for a workout. I was getting undressed, nervously, as I don't like disrobing in front of strangers. And there was another woman, a matter of a few feet away, topless, with oddly firm, projectile breasts pointing skywards.

My first reaction was shock. Two very weird, alien, unnatural body parts, brazenly displayed, right in front of me. They didn't look real or natural in the slightest. They looked like what they were – breasts that had been bought and paid for. Not soft and slightly saggy, like a thirtysomething embonpoint should be, but plastic, hard-looking and aggressively perfect. I felt like I'd been slapped in the face. They said robotic. They announced aspiration. They said "I'm considerably richer than you", and "I'm considerably more attractive than you", and even "Money well spent". For there was an unmistakeable air of conspicuous consumption in this woman's light golden tan and bizarrely pert orbs. I felt instantly sickened, and turned away.

I put it down to our surroundings, this was, after all, an overtly moneyed members' club. I told myself it was precisely these types of people – rich, successful, conventionally attractive – who had such things "done". This woman's fake, brown bosom seemed, at the time, to symbolise a jet-set lifestyle; a vulgar, ostentatious and knowing signifier of social status.

It galvanised my opinion, anyway. I didn't like what I'd seen, and would never have it done myself. But I'd always assumed men liked them. Don't all men like big, voluptuous, bountiful breasts? But that, perhaps, was where I went wrong.

A few years later, a boyfriend told me an apocryphal story about how the LA porn industry was importing Russian and Eastern European porn actresses with real breasts, because the video directors in LA were fed up with the way their American counterparts' silicone breasts didn't move and bounce with the same sensual jiggle. I'd brushed that aside, still convinced that the average man would rather fondle a burgeoning cup that had been surgically enhanced, than a modest A or even B-sized pillow.

So it was with great relief that this month I read in GQ magazine an impassioned polemic, "Fear of fake breasts", by the novelist Tony Parsons. His argument runs as follows: fake breasts are "like plastic fruit" – good to look at, but not to touch. "They are not there to be fondled, kissed or felt, they are there to be admired, discussed, lusted after and photographed. The moment they are touched – and I mean in the heat of passion, rather than out of curiosity or in the interests of scientific research – then the spell is broken. And this is true of all fake breasts, no matter how much money has been spent on this act of female self-mutilation." The scales fell from my eyes.

I'd always considered my problem with fake breasts to be just that – a problem with me. I wasn't post-feminist enough. I wasn't post-modern enough. I was still entranced by those early feminist texts I'd read aged 16 – The Female Eunuch, The Women's Room and The Second Sex, books that railed against women's representation in society as doll-like male fantasy figures. I particularly hated the idea of women going under general anaesthetic, and thus risking life and limb, to adhere to some ideal of pneumatic, Barbie-like "perfection".

So for me at least, it's been truly liberating to find that men (whom I had assumed might sanction or applaud any degree of painful female body modification if it titillates their sexual peccadilloes) feel the same way, too.

In fact, during several months of dating recently, I've found that many modern sensitive male souls are hardly the body fascists of yore. American Psycho Patrick Bateman's love of "hardbody' blonde trophy girlfriends in the Eighties was a fiction, and remains so. Men like women of all shapes and sizes. Contrary to what women themselves think about their bodies, some men find small breasts sexy; others actively prefer "overweight" size 16s over "perfect" size 10s. What's more, many men find the supposed mammarial perfection of Jordan/ Katie Price far more objectionable than women do. As an archetype of what men might like, the beach-ball sized, unapologetically false look insults both their taste and intelligence.

All of which begs the question: if they're so horrible, and men don't really like them, why on earth are thousands of woman going under the knife? As Parsons says: "Why aren't there armies of thinking women protesting about the grotesquely booming trade in bogus breasts?"

But he may be wrong on this point. Some women clearly do find breast enlargement procedures as needless as he does. "Breast surgery has become just another part of the beauty regime, like applying make-up, and it's unnecessary and unpleasant," says the writer Joan Smith, "It's treated the same as getting a haircut. It's become normalised. I think any woman considering breast surgery for cosmetic reasons should spend a month in Darfur and then decide if body image is a really important issue."

Former Cosmopolitan editor Marcelle D'Argy Smith agrees. "Fake breasts have become inescapable. But I think the main reason why women do it is to please men. They're trying to fulfil a male fantasy, and I don't think we can blame them for this. It might make them feel more confident – but it is ultimately for men." Like me, broadcaster Joan Bakewell finds the synthetic look repellent. "Fake breasts simply look false. They lack any kind of beauty or the softness associated with real breasts. Implants look like two oranges stuffed in your top. They're nothing like real breasts."

These are just a few voices of dissent. But women aren't shouting loudly enough. Yes, we may not like plastic breasts, but there is no denying they play an increasingly prominent role in our society.

Since that first shocking encounter of mine nearly a decade ago, surgically enhanced breasts – or at least images of them – are everywhere. From Katie Price to Victoria Beckham, Jodie Marsh to Pamela Anderson, with celebrity endorsement, fake breasts have lost their shock value. Brigitte Nielsen even had her breast silicone drained live on television last week.

Every series of Big Brother has a requisite pair – Lisa is this year's model, purchased by her boyfriend, Mario. There's been speculation that Britney, Nicole Richie, Jessica Simpson and Kelly Rowland have had them. It seems like these days, no one knows where real ends and fake begins – and that counts for the representation of curves in photography, too. This week, Keira Knightley made a stand against the tyranny of the unnatural bosom when she prevented the makers of The Duchess from "airbrushing" bigger cups on to her naturally flat chest.

What happens in the world of celebrity now has ramifications for any young woman who opens a magazine or switches on the television. Last year, 26,000 British women went under the knife in the pursuit of bigger breasts, and only 6,497 of those procedures were registered by BAAPS (The British Association of Aesthetic Plastic Surgeons). But even those 6,497 breast augmentation operations made it the most popular cosmetic surgical procedure recorded by BAAPS – up 6 per cent from the previous year. And then there are the ordinary housewives or girls next door (not Katie Price) checking in for their fifth or sixth op, as explored on the recent BBC3 shock documentary Addicted to Boob Jobs.

"One woman on the show had had five operations," recalls presenter Louise Roe, "three were cosmetic and two were reconstructive. One of the cosmetic operations went wrong and the implant leaked, so she had to have two reconstructive operations after that." For Roe, the most shocking aspect was that these women "were not glamour models or Pamela Anderson", but normal housewives, the sort of women you might find living down the road.

"A lot of them were very scarred from all the surgery," she remembers, "There was one lady in particular whose boobs didn't even look like boobs any more." And like some of the celebrities, a minority of patients have become psychologically addicted to having their breasts altered and end up having multiple ops, hoping that each expensive procedure will help them attain an acceptable body shape.

A breast augmentation isn't like going for a blood test. Normally, it is a two hour general-anaesthetic-and-all operation, with all the usual risks of organ failure and cardiac arrest. After a successful procedure, drainage tubes are placed in the incision for several days to help eliminate excess fluid. The chest is wrapped in gauze for a week, and the patient is advised to minimise arm movements to prevent separation of the muscle and tissue around the implants.

The enhanced breasts will still droop with age, and implants have a lifespan of around 16 years, so, depending on the woman's age, will need replacing. Then there's the cost. Although prices have become more "competitive", the guide price for breast implants at Transform, a national chain of cosmetic surgery clinics, costs £3,950 for the round, silicone type. Teardrop shapes are more expensive. "Glamour model" sizes are pricier still, since they have to be ordered specially from the manufacturer.

The fallout from the less successful procedures can be catastrophic: even the best surgeons admit that risks include lumpy-bumpy appearance, indentations, mismatched breasts, infection, loss of sensation, formation of calcium around implant, bleeding, blood clots, skin loss and implant rupture or leakage.

The advent of the casual, lunch-hour op – this week, Sarah Cox, a 27-year-old beauty therapist from West Bromwich, proudly showed off the results of her injectible boob "jab" in one paper – hardly seems to offer a better prognosis. Why any person would risk so much because a B cup "just wasn't big enough" seems a triumph of folly over reason.

The vogue for breast enlargement began more than 50 years ago. At the tail end of the Second World War, Japanese prostitutes started having freely injected silicone liquid pumped into their breasts to please the US GIs. This turned out to be a disaster, as rudimentary silicone often hardened, or became lumpy and infected. Surgeons went back to the drawing board, and by the early Sixties had developed the modern breast implant: two sacs of liquid silicone, packaged in a shell which is then inserted into the body in its entirety.

Those used in the Sixties are termed by surgeons as "first-generation" implants, because they had a thin shell and liquid silicone inside which often went lumpy or coagulated at the lymph nodes. We are now, in the Noughties, on the "fifth generation", and have been for eight or nine years. The contemporary implants have thicker shells and semi-solid silicone gel within. Surgeons claim they are much sturdier – so if they do break, a patient should not experience leakage.

In the late Eighties, silicone implants became the subject of controversy in the US when a group of women made a claim that augmentation had caused connective tissue disease (similar to rheumatoid arthritis). The press soon got hold of the story, and the safety of fake breasts became a full-blown health scare. In 1991, the US government imposed a moratorium on silicone implants and subsequently a huge amount of research was carried out worldwide exploring the link between silicone implants and connective tissue disease or breast cancer.

It was proved that there was no link, and in 1998 the British government published a directive that silicone implants are safe. The US moratorium on silicone was lifted this year. "Silicone is undoubtedly the best implant material," states consultant plastic surgeon and BAAPS member Patrick Mallucci. He explains how various substitutes have been suggested but in trials all turned out to be disastrous. Soya implants, for example, were deemed to be unsafe around 2000 to 2001, and all women with them ended up having them removed and replaced with silicone.

Surgeons such as Mallucci are indignant about the exposure of breast implants in the media. He claims that many women in the celebrity spotlight have implants through vanity and the desperate search for fame, which he, like me, finds deeply problematic. However, he reckons that the majority of his patients are women with mastectomies seeking reconstructive surgery, women who've been born with unnaturally flat chests and women whose breasts have been "devastated" post-pregnancy. "Very few of my patients are the glamour model types we see in the media," says Mallucci. "I tell them to go to somebody else if they say they want to be like Jordan."

Mallucci points out that very extreme augmentations, such as those belonging to Katie Price, Pamela Anderson and glamour model Jodie Marsh (who recently got a "double-G cup" boost) can ravage the human body and lead a patient on a rocky road towards further corrective operations. "Big implants cause drooping over time, they stretch the skin and squash the breast tissue. Women who've had them will definitely need more operations over time which will, in turn, cause more scarring."

Despite Mallucci's protestations that the majority of women are not having implants for vanity reasons, the message conveyed by celebrity magazines is that a boob op has been the answer for women who've felt dissatisfied with a B cup and wanted a little boost to a double D, or more. And primarily, it is this solipsistic vanity and nouveau riche ostentation that I object to. I have no issue with the woman who has had a mastectomy. Or the woman whose breasts, abnormally, did not develop at puberty. What I have a problem with is believing that it is acceptable for consumers to treat themselves to new breasts as they might a new handbag.

The proof, if further were needed, of this dangerously casual attitude to potentially life threatening surgery, are the numerous ads in the back of glossy magazines and on platform-side advertising on London's Tube. Companies such as Transform and the Harley Medical Group present the acquisition of fake breasts as being a consumer choice comparable to the purchase of a new car or a sofa, with pay-by-instalment price plans to boot.

So I take heart from Tony Parsons and his "Fear of fake breasts". If only there were also men out there who would rail against all the other elements of porn culture that seem to have invaded and pervade our everyday lives and beauty predilections (the orange tans, Hollywood bikini waxes and bleach-blonde extensions...) But women, too, need to stop aspiring to the fake silhouette.

Perhaps my greatest fear about the rise of the fake breast in Western culture is that, like Botox and facial surgery, it attempts to cheat ageing and mortality itself. Women want new breasts for a variety of reasons, but those in their thirties and forties who have augmentations because their bosom was slightly sagging are attempting to turn back the clock.

Surely, like facial wrinkles, we need to learn to love the slight imperfections that ageing bestows. These are signs that our bodies have travelled and worked and experienced emotions, not scars or disfigurements that should be erased.

If Parsons is paradigmatic, then men aren't half as critical of our bodies as women might imagine they are. And while male approbation is the last reason women should avoid cosmetic procedures, we need to start loving ourselves a little more and stop worshipping dumb-assed celebrities who mutilate their breasts in the name of vanity.

Love what you've got, girls! Don't succumb to the knife!