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Tuesday, January 17, 2006

Byline: Jodi Mailander Farrell

MIAMI _ Melissa Gonzalez knew her family intended to give her enough money to buy a new car when she turned 18. But she had her heart set on something else: Bigger breasts.

After convincing her mother she was serious, Gonzalez spent about $5,000 augmenting her breasts in April, one month shy of her 18th birthday. She grew from what she calls a "flat-as-a-wall" double-A bra to a small C-cup. She spent the rest of her birthday money on a used 1999 Mercury Cougar.

"At first, everybody was like, `Oh my gosh, I can't believe you're doing this,' " says Gonzalez, a sophomore at Florida International University. She says she "was always super-self-conscious" and had been determined to get implants since she was 14. "I wore a padded bra underneath a sport bra just to give myself a little bump. I didn't have cleavage; I didn't have anything, no matter how much I squished. This is something I did for myself. I just wanted to look like a girl. Girls have boobs and hips, you know what I mean?"

Gonzalez is not alone. In just one year, the number of girls 18 and younger getting breast implants jumped nearly threefold_from 3,872 in 2002 to 11,326 in 2003, the American Society for Aesthetic Plastic Surgery reports.

A LARGER TREND

With financing making more accessible than ever, it's not just teenage girls getting implants. The increase in young women undergoing procedures mirrors a larger trend in our Nip `N Tuck nation. Among all age groups, cosmetic implants have skyrocketed in popularity, according to the American Society of Plastic Surgeons. Last year, the group reports, about 247,000 women got breast implants, compared with 32,000 in 1992.

By comparison, teens are still a small percentage of those receiving implants, points out Dr. Barry Schwartz, a Weston, Fla., plastic surgeon. Schwartz says about 15 percent to 20 percent of his breast augmentation patients are under 21.

"Young women are more conscious of their bodies in this day and age, especially with South Florida fashions," Schwartz says. "The more you expose, the more you want to look good."

Dr. Jose M. Soler-Baillo, a South Miami plastic surgeon who performed Gonzalez's augmentation, says getting implants has become a "coming-of-age type of thing" for many young women, "especially here in Miami."

"I've definitely seen a steep increase in 18- and even 17-year-olds coming in," says Dr. Lenny Roudner, who is so popular among women seeking implants that his nickname is "Dr. Boobner." The Miami doctor performs an average of five implant surgeries a day.

"These girls are really well-informed," says Roudner, who has worked on some young patients' mothers and grandmothers. `When the mother has had it, she knows what it did for her, so these women are quite fine with their daughters doing it. It's a big boost to some girls' self-esteem. It's becoming quite the graduation gift: It's cheaper than a car and better than a fountain pen."

Critics say the timing couldn't be worse for adolescent girls, who are often unhappy with their looks. They say teenagers are too young and shortsighted to comprehend the long-term affects of surgery, particularly the risks, which include the possibility of rupture or permanent scarring, the need for periodic operations to replace or remove the implants and the potential problems with breast-feeding and mammography. Also, little is known about the implants' long-term safety; no studies have been done on females this young.

"It might feel to a 17-year-old like it's the end of the world to wait a few years, but their bodies are still changing," says Diana Zuckerman, president of the National Research Center for Women & Families. `Those breasts are likely to get larger, especially when they go off to school and gain the `freshman 15,' the pounds girls often put on between ages 18 and 21. Their whole body begins to look more voluptuous."

The nonprofit research and education group is so concerned about the trend that it has created a Web site, www.breastimplantinfo.org. The site includes details of surgery risks, graphic FDA photos of women whose procedures have gone awry and an online hotline_info(AT)breastimplantinfo.com_for girls to e-mail questions.

Among the young women featured on the site: Kacey Long, who got D-sized implants three years ago at 19. A few weeks after her surgery, Long says she began experiencing shooting pain in her arms, followed by intense joint pain and crushing fatigue. Last year, her parents took out a $6,400 loan to pay for removal surgery, a procedure documented on MTV's "I Want a Famous Face."

There is no law forbidding implants in patients younger than 18, but the FDA advises against it. In the past 15 years, implants have been the subject of furious controversy over their safety. The FDA has banned silicone-gel implants because of unanswered questions about their safety, but it permits the use of saline-filled implants, which have a silicone shell. Both types are the subject of ongoing FDA studies.

SOME GET TURNED AWAY

Zuckerman, the mother of two teenagers, says girls should wait until they are 21 to consider breast surgery.

Some local surgeons say they have turned away girls younger than 18, primarily because their bodies were still changing.

"You want to be sure that, physically, they're done growing," says Dr. Tracy Baker, a Harvard-trained Miami plastic surgeon. "It's like building a house on ground that's shifting or settling."

Baker says he considers the age a girl started menstruating and whether or not her shoe size, height and weight have remained constant. Soler-Baillo, the South Miami surgeon, draws the line at age 17 in most cases, although he recently performed surgery on a 16-year-old because she had one undeveloped breast.

"The key thing is to have the parents involved and have a mature young person," Soler-Baillo says. "I spend at least an hour interviewing and asking questions like `Why are you doing it?' If somebody says, `My boyfriend likes big boobs,' that's not the right answer. But if they say they can't find clothes that fit, that they don't feel comfortable, it means they're not doing it for somebody else, it's to make themselves feel better."

Soler-Baillo and other surgeons say they warn young women about the pain of surgery and the possible complications.

"If an 18-year-old girl comes in with a beautiful B-cup, I'm probably not going to operate on that girl, but if there's a girl going off to college or entering the dating world and she's mature and really has no breast development, that is a problem for that young woman," Baker says. "It affects her self-esteem, her clothes, her dates."

Melissa, who asked that her last name not be used, underwent surgery after graduating from high school earlier this year because her left breast was a B-cup size and her right was an A-cup. Now she's a 34B in both.

"I'm so happy now, I'm proportional," says the 18-year-old.

Luly Martinez, a legal assistant in Miami, says she is waiting for her daughter Alexa to stop growing before she agrees to implants, probably sometime after the 17-year-old graduates from high school _ and after Mom gets hers done next year.

"I'll get mine first, then we'll get hers," Martinez, 36, says. "She's dying for them. To me, I think she's perfect, but she wants them bigger. When she starts working, she can pitch in."

Alexa, who says she wears a 34-A bra, wants to be a "full B or C cup." The 5-foot-2-inch teenager weighs about 110 pounds.

"I just want to be bigger so I can wear nicer shirts and things can fit," she says. "I want it for myself so when I go out, I'll look better in what I'm wearing."

Nicole, another Miami implant patient who asked that her last name not be used, says she underwent surgery at age 19 as a reward to herself for losing 35 pounds. She went from a 36AA to a 36C.

"I got into bodybuilding and got very muscular and I didn't have anything," says Nicole, now 20. "I just felt very insecure about my body."

Nicole's parents weren't happy with her decision, but they eventually accompanied her on a pre-surgery office visit and gave their blessing, in part because Nicole paid for the procedure. Using money she had saved since she was 15, she made a down payment of $2,850 and financed the last $1,500. She researched the issue and doctors on the Internet, concerned because her family has a history of breast cancer.

"I chose to pay for it so I can never blame anyone for it if something happens," Nicole says. "If things do happen, I will have to suffer the consequences for something I decided to do."

Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania Medical School, says he advises against implants for teenagers primarily because they will have to be redone.

"Saline tends to lose shape, shift a little, they get pushed around a bit so they have to be replaced," Caplan says. "The younger you get them, the more you're going to have to go back and replace them.

"I'm not trying to argue this is something we should ban or outlaw," he says. "What I'd like to see is young people thinking a little bit more about what really matters to them. It's all about giving yourself a chance to get comfortable with your body and what message you want to send to others. But do I think I have a snowball's chance in hell of changing things with this advice? No."

Melissa Gonzalez, eight months into her new breasts and happy to be wearing V-neck shirts, says the procedure was worth it despite the potential for future problems.

"Some things just happen, one could pop, I know," she says. "But it's like life: Whatever happens happens. At least I have them at a time when I can enjoy them."

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