Silicone City
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“Look at this. She’s very boyish,” Rose says, taking a felt-tip marker to Melissa’s breasts. “Barely an A cup.” Rose is one of the handful of doctors still permitted to use silicone-filled implants as part of an experimental program; because Melissa is thin and her chest is slightly concave, she is a perfect candidate for the highly controversial silicone implants instead of the saline kind approved for the general population by the FDA. Saline has proven far less popular than its predecessor. It tends to ripple on younger women with tighter flesh, producing what Rose calls “a cosmetically displeasing event.” Melissa and her mother are rare because neither has been swayed by the torrent of publicity and lawsuits suggesting a link between silicone implants and diseases of the immune system. “I’m not afraid of silicone,” declares Cyndi, who hopes to have her saline implants replaced soon.
There is nothing sensual about the way Rose handles Melissa Lovell’s breasts over the next forty minutes. After taking measurements to establish symmetry, he injects each breast with a drug to reduce bleeding. Then he makes a small incision under the right breast and, using scissors, a high-tech scraper, and a small light that reveals the interior of the breast to be both red and bright yellow, snips and pushes tissue aside to make a pocket for the implant. Shoving in the gel-filled sacs—enough to make the young woman a C to D cup, today’s breast size of choice—is something akin to giving birth in reverse. Rose pushes and prods Melissa’s breasts in a way that no conscious woman would permit, slapping them, squeezing them, molding them, sometimes stopping to shake the cramps out of his hand. Near completion, however, pride replaces frustration. “She’ll have a lovely result,” he coos. When he is done, Melissa has two volcano-like peaks on her chest that should, in the course of a few weeks, settle into soft, robust mounds.
Awakening briefly after the surgery, Melissa surveys her chest and smiles dreamily. “I’ve got boobs,” she says and then slips back into sleep.
“For some years now, at least in the United States, women have been bosom conscious,” Thomas Cronin and Frank Gerow, the inventors of the silicone-gel implant, wrote in the early sixties. “Perhaps this is due in large measure to the tremendous amount of publicity which has been given to some movie actresses blessed with generous sized breasts. Many women with limited development of the breasts are extremely sensitive about it, apparently feeling that they are less womanly and therefore, less attractive. While most such women are satisfied, or at least put up with ‘falsies,’ probably all of them would be happier if, somehow, they could have a pleasing enlargement from within.”
So went the rationale for the silicone-gel implant. Cronin, a clinical professor of plastic surgery at Baylor, and his resident Gerow, surely wanted to help women who had endured mastectomies, but the greater goal was to help the large number of flat-chested women be “happier.” The surgeons were typical Houston innovators—like those in the oil fields and those at NASA—who believed firmly in their right to improve upon nature and to bring glory upon their organization, which in this case was the young, ambitious Baylor University College of Medicine. If Michael DeBakey could repair a heart, Baylor’s cosmetic surgeons could build a better breast.
Cronin and Gerow, both of whom have died in recent years, are remembered by their colleagues as supremely dedicated. Cronin, a native Houstonian, is recalled as a polished, remote figure with a River Oaks address; his charity work is well known, as are the advances he developed for victims of burns and those with hand injuries. “He had a very large ego that was well contained,” says a former protégé. Gerow was just as devoted to his work but far more approachable. A Canadian immigrant, he arrived in Houston with little money; at first, he and his wife lived in an unair-conditioned home, and his idea of relaxation was to quiz his students in the back room of the Bacchannal, a Greek restaurant with belly dancers. “He was a genius,” says a colleague. “As soon as he found out about any new surgical procedure, he’d start modifying it.”
It did not intimidate these doctors that women’s breasts had long defied modification. Visionaries had been trying to improve upon nature for centuries, inserting such things as paraffin, ivory, animal fat, and sponges into the breasts—with no success. Silicone was first used after World War II when Japanese women, who tended to be smaller-breasted than their American counterparts, had it injected into their breasts to please American servicemen. The trouble with these augmentation procedures was that the substances didn’t stay where they were supposed to or the breast became too hard or the patient became extremely ill—or all of those things. The story goes that Gerow solved the problem one day at a blood bank when he first saw blood in a plastic bag as opposed to a glass bottle. He squeezed the bag, and it reminded him of…a breast. So, working with associates of Cronin’s at Dow Corning, the doctors experimented with a bag filled with silicone gel, and gradually, the silicone-gel implant, or “natural-feel prosthesis,” was perfected. Silicone was considered the perfect filler because it was heavier than water—closer to the real thing—and was believed to be inert; that is, nonreactive with body chemistry. Patients were told that the implants were safe and that they would last forever, because that was what the doctors believed. “They’re as harmless as water,” Gerow used to say.
In the beginning, the only notable problem was what came to be known as capsular contracture—the body tended to wall off the implant, forming a “capsule” of scar tissue that distorted the breast. To treat the problem, doctors did everything from massaging patients’ breasts to pounding them with medical textbooks; one journal even ran a story to help doctors with their hand pain. In the early eighties, the outer shell of the implant was thin and textured to abate scarring; it helped, but some say it caused more-serious problems, which went undetected for years. In early photographs, implanted breasts looked less like real breasts than hyperreal breasts, perfectly symmetrical and pointed, in the torpedo style fashionable at the time.
It isn’t hard to understand why the operation was popular throughout most of the sixties, when a big bust was the prevailing symbol of femininity. But, ironically, when fashion ideals changed—remember Twiggy?—and feminism attacked the treatment of women as sex objects, demand for breast enhancement grew. A new generation of Baylor residents, trained by Frank Gerow, perfected their talents on homemakers and secretaries, psychologists and elementary school teachers. It particularly appealed to young white women who worked among powerful white males: on airplanes, in hospitals, in law firms, and in courthouses. Though most women asked to be made “normal,” what came to be normal in Houston was larger that the national average—a C cup.
When women try to explain why they so craved this surgery, they mention almost universally that they believed it would help their “self-esteem,” a pop psychology term vague enough to mean just about anything. That was equally true of the desire for enhanced breasts in the seventies and early eighties: A new, improved bust line could be the solution to any and all inadequacies women were feeling during a time of enormous social and sexual change. The augmentations could ease a woman’s retreat from the pressures of feminism, signifying a return to more-conventional notions of womanhood (“My husband loves ‘em!”). Or they could simply make the breaks available to naturally busty women—better service in restaurants, free upgrades on crowded airplanes—available to everyone. Side effects like breast hardening and reduced sensation were of little concern. Women were used to suffering for beauty.
And boob jobs were cheap. In the seventies, a middle-class shrinking violet could have the same breasts as a movie star for about $4,000. “This was something that a secretary, a nurse, someone in college could afford. It wasn’t like a face lift, which was for the carriage trade alone,” says Houston cosmetic surgeon Laurence Wolf. The doctors and hospitals loved it almost as much as the patients: The surgery was not covered by insurance, so there were no reimbursements to wait for. Augmentation mammoplasty was strictly COD. (Eventually cosmetic surgeons got the best of both worlds, lighting on a reimbursable category for extreme flat-chestedness called hypoplasia.) “It was,” says Wolf, “a happy operation.”
And the best was yet to come.
When Robert Watters talks about silicone breast implants, an unwelcome wind of negativity ruffles his cool, supremely confident demeanor. “I preached against them for years,” says Watters, 44, who is the owner of Rick’s Cabaret, the most famous topless bar in Houston, and perhaps, the world. To him breasts aren’t the point. “We’re a species of weak egos,” he says in an almost professorial tone from the dim balcony of Rick’s VIP Room, the place where the likes of Warren Moon and Sting have gotten a very special eyeful. According to Watters, Rick’s isn’t about breasts; it’s about seduction. Personality, not surgery, salves the lonely, hungry hearts of men. “You come into Rick’s and, for the grand sum of $20, you can buy the individual sexual attention of a woman for five minutes.” Luckily for Watter’s business—and that of the silicone-gel implant—the topless dancers who worked in his clubs didn’t quite see it that way. “In the early and mid-eighties, the first material acquisition the dancers saved for,” he admits, “was breast augmentation.”
