Keeping up appearances

Breast jobs are more popular than ever, but it's the middle classes who are the new candidates. Businesswomen, mums, marrieds and over-40s are all getting in on the act, but you wouldn't know it. Our correspondent reports on the subtle new teardrop shape that gives you back your twentysomething figure.

Sunday TimesKeeping up appearances

I'm cupping a set of perfect breasts. They overspill my palms a little - they are roughly a C - so it's hard to keep them steady. Their shape - round, medium projection - is what many women dream of. Well, they're not breasts, strictly speaking. I am holding a set of £200 (wholesale price), state-of-the-art silicone implants. In these clear, rubbery sacs, filled with something that looks like grey turkish delight, lies the key to happiness for a fast-growing number of British women.Breast enhancement is now the most common cosmetic-surgery operation in the western world. In Britain, boob jobs have been steadily gaining popularity since the 1960s, but last year the number of operations rose by 30%. The official statistics from the British Association of Aesthetic Plastic Surgeons (BAAPS) say that 6,156 breast augmentations were carried out in 2006, but, since many practitioners are not members of BAAPS, experts agree that trebling that figure would give a more accurate picture. Talk to any surgeon, and they'll tell you that the reason for the sudden increase is that intelligent, middle-class, thoroughly un-Barbie-ish women want to improve their cleavage - subtly. The women looking for juicier jugs are not dolly birds. They are businesswomen, mums, marrieds, divorc? and well over 30. They don't want Playboy-bunny, look-at-me tits - they just don't want pity-me ones. These are women whose beauty icons are Cate Blanchett and Nigella Lawson. They don't even want new boobs, really; they just want the old ones back. And, these days, they can get them. Changes in the operation have helped: the old-style missiles occurred because the silicone sac (saline was always the other option, but, frankly, not as good) was placed on top of the pectoral muscle. For the latest "teardrop", Liz Hurley-style shape, you can elect to have the sac placed under the muscle. You can also choose a slightly pendulous silicone sac, to avoid the lap-dancer look. Dai Davies, one of Britain's most in-demand cosmetic surgeons, says: "Fifteen years ago, the typical woman coming for breast surgery was young and single and sort of out there. They wanted bigger, rounder, noticeable breasts. Now, she's in her late thirties to early forties, she has had a couple of children and she wants something discreet. Something her friends may not even notice, but that will make her feel more confident and look better. Over time, women lose volume from their breasts, and the typical candidate now wishes simply to correct that." Patrick Whitfield, Medical Director of The Harley Medical Group, has been fine-tuning breasts since the 1960s. "There will always be young girls who want them as big as they can get them, but most women now want a natural look, and the clientele is getting older. I gave a 56-year-old woman implants recently. They were a wedding present to herself." Even a decade ago, a grown-up woman might simply have accepted the state of affairs on her chest once it had passed its peak pertness, and booked an appointment at Rigby & Peller. But no longer. In the 21st century, there's a sense of injustice at what happens to our breasts when we hit our late thirties. If you embrace complex carbohydrates, Pilates, Crème de la Mer and a good hairdresser, you can look roughly as hot at 38 as you did at 26, but without a bra, your rack will let you down, especially if you've breast-fed a baby or two. There are no muscles in our breasts that we can train or tone into youthful submission. Tits can't lie. Tits will say you're middle-aged at 35, regardless of whether the rest of your body submits to age. Getting them to keep shtoom costs about £4,000. Louise, who runs a business in Harrogate, has just celebrated her 35th birthday. "I felt I was in my prime, but my boobs were like empty sacks. After I had my daughter, who's now eight, I was a size 16. I finally lost the weight and got down to a 10. Everyone thought I had the perfect figure, and I did look good in clothes, but I was so unhappy with how my body looked naked. I hated taking my bra off in front of my partner. I even kept it on for sex." Six months ago, she got some round, softly pointy implants, and she says she couldn't be happier. Two of her friends have followed suit. Once they've had the operation, many women find scores of others coming out of the closet. Julianne, 40, who has just come back from a holiday, says: "It was the first time I'd been in a bikini since I'd had them done, and I've got to say it was a wonderful feeling. My bust isn't much bigger; it's just better. Once you've had them done, you find it very easy to spot others who have, and there were plenty round the pool. By the end of the holiday, we were all drinking cocktails and comparing notes. It is a comfort to know that everyone's doing it." It has to be said, too, that plastic surgeons have benefited from Britain's rising number of failed marriages. One postop woman told me: "I didn't mind my exhusband seeing the state of my boobs. At least he knew what they were like when I was 25, and he appreciated the work my breasts had done for the children we had together. We split up when I was 41, and the thought of being back on the market with tits like floppy puppy's ears was too much to stand." The middle-youth clamour to go under the knife also reflects a new confidence in the very notion of cosmetic surgery. A few years ago, a filled-out bosom was something of a freak show. We associated it with the likes of Lolo Ferrari and - bless her - Dolly Parton. Collectively, surgeons in Britain now have tens of thousands of successful operations under their belts, and there is a wealth of expertise in London. Rajiv Grover, a sought-after Harley Street surgeon, says: "Women are a lot more knowledgeable about what is available. They are aware that implant technology has come on in leaps and bounds. There are rarely concerns about the safety, and they know they can have a natural-looking result. They don't have to have a shelf under their chin; they can have a gentle slope - something that's appropriate for their age." With all the talk of perfectly angled nipples and just-so gradients, it's easy to forget that there is a rather gory operation under general anaesthetic at the centre of things. The typical, simple operation involves a 2in incision at the bottom of the breast, through which the implant is fed. Some choose to be cut under the armpit for discretion's sake, or, in very rare cases, the bellybutton. Some even have a postpartum tummy tuck and boob job simultaneously - with the surgeon tunnelling upwards through an opening in the belly. If an uplift is included as well as an implant - increasingly common for the new breed of client - the nipple is cut out around the areola and repositioned a few centimetres north. According to the plastic surgeons, you are officially droopy if your nipple is below the crease under your boob. Sufferers can probably hold a pencil or two, hands free. The cost of correcting that sorry state and popping in some implants is about £6,000. Cynthia, 38, a divorcee from north London, was "lifted and filled" a year ago: "I sort of blanked out the fact that there'd be an op and thought only of the end result. I woke up with these ridiculously swollen orbs. Nobody had misled me, but I was shocked. There was a lot of water retention, and they were tender and uncomfortable. It was a week before I got a proper night's sleep. I'm so happy with my body now; I wouldn't have it any other way. I just hadn't considered the discomfort that would come." There are other downsides to consider. Capsular contraction, a condition in which the breast hardens as a reaction to the introduction of a foreign body, occurs in about 5% of women. Of course, there's no way of telling beforehand whether your body will react in this way. Some just live with the unsatisfactory result; others have the implants taken out. The hardening can occur up to two years after the operation, and not always in both breasts. One surgeon I spoke to suspects that capsular contraction provides an explanation for Victoria Beckham's unaccountably fierce bosom. "The fact she is so slight doesn't help, but they aren't right." He was not the only surgeon to say that one of the most common worries expressed by thirtysomething patients was that they might end up with Posh boobs. Silicone leakage, however, is no longer considered a worry. A study by US surgeons last year found that, after 12 years, only 8% of women had even the slightest problems with their implants, and those were more likely to cause discomfort rather than any serious health issues. How they feel is another consideration, and although, according to surgeons, man-pleasing is rarely the motivation for the new candidates, men do, inevitably, become closely acquainted with them. One told me: "I'm happy that they make her happy, and they look great, but they don't feel real. They spring back like firm jelly when touched, and you can feel the edges." For thin women with little breast tissue, an implant under the muscle may look and feel more natural, but in truth, the only things that feel like real breasts are breasts. One problem with saline implants was that they would feel cold in winter. Says Grover: "Silicone is a better conductor of heat, so they feel warm. A good surgeon will make sure they feel as well as look good, but the better endowed you are to begin with, the more natural they feel to the touch." To avoid an unsatisfactory outcome, picking the right surgeon for the job is key. Wendy Lewis, the renowned "knife coach" who gives independent advice to Park Avenue royalty and wealthy UK clients, says: "It seems a simple operation, but the more experienced the surgeon, the better the result will be. If the surgeon doesn't take very detailed measurements, run. Breasts are like snowflakes: everyone's are different. Even the two you have are unlikely to be identical, and you need careful consideration about what to do with them."Link to Times Online articleRead more about breast enlargement, breast uplift procedures and our cosmetic surgery guide.Contact us today to book your free breast enlargement or breast uplift consultation with one of our highly qualified Nurses.