Breast Implant Business Booming

Three months ago Irina was deeply depressed. She feared the arrival of summer when her flat chest would be exposed. After breast-feeding two babies her breasts had become so small they made her cry.


Irina's tactful husband never commented on the matter, but she was desperately losing her confidence so she decided to get her breasts enhanced with silicone.


"The result exceeded all expectations and my husband is delighted," said Irina, 35, a gynecologist. "Imagine -- I didn't have any chest, and now I have one."


In the past seven years, about a dozen private cosmetology clinics have sprung up around Moscow to help women like Irina.


Soviet dogma dictated that, while it was O.K. to have an operation to repair the ravages of an accident, it was shameful to make yourself look more beautiful through surgery. But now Russian society has become more open and beauty-conscious women don't hesitate to spend thousands of dollars in pursuit of perfection.


The price tag for a breast implant is rather lofty, costing from $400 to $1,400, but it is still at least two times less expensive in Russia than in the West. Russia's inexpensive prices are attracting even Western clients to well-reputed Russian clinics, breast-implant surgeons say.


Dr. Vladimir Marenich of Moscow's Mediton Clinic said when the plastic surgery boom started in 1994, he did 200 breast jobs a year. However, since other clinics have opened, his business has decreased by half.


"What is a breast for a woman?" Marenich mused. "It is something without which neuroses occur, families fall apart and lives shatter."


Silicone, developed in the 1960s, is the most popular breast-implant material, both in Russia and worldwide, doctors said. It has a dough-like consistency, similar to a breast.


"You install it and get a soft, normal breast. A man would never figure it out, if he is not a doctor," Marenich said.


Most women who come to Marenich's clinic for breast implants aren't looking for the chest of a Playboy bunny, the doctor said. Artificial looking breasts are the result of choosing a size larger than is anatomically feasible with breasts that are too heavy for the woman's frame, he said.


Much more popular are implants shaped like natural breasts. Currently fashionable are moderate-profile, drop-shaped implants filled with gel that have textured covers to keep them in place, Marenich said.


Preferred sizes vary from continent to continent. In Europe and Russia the most popular volume is between 180 and 270 milliliters, while American women seem to prefer larger sizes ranging from 270 and 450 milliliters, Marenich said. An implant can be installed for a lifetime, but usually in 10 or 15 years it starts to sag and a bigger size is needed.


About 15 percent of the women who have breast-implant surgery choose the poorer quality Russian implants that cost only $400. In the majority of the cases, these implants are rejected by the body, which forms a painful protective tissue around the implant that must be surgically removed, doctors said.


"The difference between a Russian and a Western-made implant is the same as between a Moskvich and a Mercedes," Marenich said.


To prevent such problems, more women are choosing Western models, the most popular of which are implants made by the U.S.-based McGhan company. Only 5 percent of the women with McGhan implants, which cost $1,400, experience complications, Marenich said.


Probably the most dangerous of Russian implants is hydrogel, which was banned in the West but is still occasionally used in Russia. The gel is injected into the breast, filling all the space between the tissue and makes the breasts sore and unnaturally dense. The only way to get rid of the implant is to cut it all out, along with the breast, doctors said.


Breast augmentation is a simple one-hour operation that is almost bloodless and leaves no ugly bruises. The implant is inserted into the space between the muscle and the mammary gland through the underside of the breast, the nipple or the armpit. The stitches are removed in a week, but the patient still feels an added weight in the chest and some pain for about month after the operation.


The average age of Marenich's patients is from 30 to 35, and the oldest woman he operated on was 45 years old.


"Beauty is a very subjective thing. I rely on the taste of the patient and the contemporary idea of beauty," he said, showing a postcard from a client in which she called him an "artist."


Marenich said many of his clients come to him because they are discontented with life.


"They start making huge plans for a new, more beautiful life, after a girlfriend who installed implants marries a foreigner," he said.


While Marenich's clients are mostly middle-aged women with children, a lot of women who come to Gennady Osipov of CLAESPO clinic are younger -- between 16 and 35 years old.


Osipov, who also teaches plastic surgery at the Russian Academy of Medicine, said he has treated foreign clients from Israel, Poland and the United States where the cost for a breast job ranges from $5,000 to $12,000.


He operates on an average of 100 patients a year, especially in the spring when women prepare to hit the beaches.


Among them there are many models and prostitutes, some of whom want breasts that are just too large for their frames, Osipov said. He recalled a slim 18-year-old Russian woman who tried to persuade him that she needs large breasts, showing him a photo from a German porn magazine picturing huge, pendulous breasts.


"The woman's private life is not my business," Osipov said. "I only care about her physical and mental health. But in this case the girl was obviously a young prostitute with an offer to work in the Arab Emirates or something. I had to turn her down saying that it is impossible for aesthetic and physiological reasons."