There was a time in my life when I was very cool, current, up to date with popular culture. I knew who celebrities were, and I could stand my ground in most conversations about fashionable things. I even went to fashion school! But in the many years since, my time has become monopolized, and I find myself predictably out of the loop. This is where I look to my patients to catch me back up.
When I consult patients about breast surgery, whether they are looking to go bigger or smaller, I often ask them what their goals are. Quantifying breast size is challenging, especially since cup sizes are anything but an exact science. What works for me is a combination of breast marking and photo showing. For the first part, I reposition the breast and mark out what my understanding of their target size and shape might be. This is a very good jumping off point. For the second part, patients show me pictures of sizes or silhouettes that line up with their personal goals. For this, they often use a combination of photos from personal friends, online before and afters, and of course, celebrities.
Many years ago, the standard of beauty for most cosmetic surgery patients was full volume. This was best exemplified by icons like Pamela Anderson, whose chest had its own celebrity status in the Baywatch years. But over the last decade, this standard has shifted. Instead of trying to figure out how big an implant can fit in the pocket, it has become a game of figuring out how small you can go with the given surgical technique.
As a lifelong beauty advocate and designer, I have always found small breasts to have a uniquely beautiful quality. When I started out in solo practice, I had to special order implant samples for my office because all of the ones the manufacturers had available were at least double the size of what I generally use. I have consulted countless patients who tell me that they have been told by other surgeons that they don’t “need” to go any smaller, “why would [they] want to?” I have even heard someone say once that “anyone who performs a breast reduction should be shot.” That, of course, was not a person with breasts.
When I ask people to show me a picture of their target shape, eight out of ten show me the same one. And seven of those eight show me the same person: Zendaya. The conversation begins with me asking “Do you have a target profile?” And the answer I most commonly get now is “Do you know Zendaya?”
The first time I was asked this question, I said no. The patient then took out her phone, found one of many gorgeous photos of her, and then flashed me a glance. “I love that,” she said. “It’s just so delicate and pretty.” I agreed. By the next month, it became an echo in my office. At least twelve people had asked me the same question, except now I knew exactly who they were talking about.
As with many things, I have found myself to be the odd man out when it comes to breast procedures. I have downsized implants, lifted without augmenting, and minimized macromastia for almost 14 years; and one thing is becoming increasingly clear: the smaller I go, the happier they seem to be. This used to be my own little world, one where women often said “I’m so glad I found you. The three guys I met before you refused to discuss such a small size.” This never made sense to me, but to each their own I guess. But it would appear that the trends are finally catching up to me these days, and less is truly more. I have never minded being different – it is the story of my life in many ways. There is some validation to seeing that the trends are evolving in such a meaningful way, even though I have been entirely content being unique. Maybe now that this is a new beauty ideal, I can once again claim to be cool. Either way, I am very excited to continue to validate women as they embrace more natural contours and answer only to themselves. This can only be evidence of things moving in the right direction.
