It's thanks to the genius of saline and silicone.
To be sure, breast implants are on the rise everywhere. In 1992 there were 32,000 breast implants in the United States. Last year that number had soared to more than 300,000. But in beauty-obsessed Miami, the trend is even more pronounced. After all, the place was inspiration for plastic surgery television shows like Nip/Tuck and Miami Slice. Get-a-free-set contests (like one run by this newspaper) are oh-so-ordinary here. And bargain-basement deals and financing plans are pitched used-car style: The average price of an American breast job was $3373 in 2005; in Miami you can find them for $1999!
Although the American Society of Plastic Surgeons doesn't keep stats on the number of implants in each city, some local implantologists believe Miami might even exceed traditional silicone hotbeds like Los Angeles and Las Vegas as the Fake Breast Capital of the United States.
For one, we're stuffed with plastic surgeons — there's one for every 28,500 of us (in La-La land, they make do with one per 43,000). Moreover we're a fake-boob destination. Dr. Onelio Garcia, a Hialeah cosmetic surgeon and former president of the Florida Society of Plastic Surgeons, who has performed breast augmentations for more than twenty years, says women from all over the world come here to have their breasts done.
Garcia also notes that Mentor Corp., one of two major implant-makers, has a sales rep dedicated exclusively to Miami-Dade County. In some parts of the country, Garcia says, a rep covers a four- or five-state area. (Mentor declined to comment about its sales force staffing, but a spokesperson acknowledged that Miami is a good market.)
Here in the Magic City, fake breasts went mainstream long ago. They aren't just for strippers, party girls, and wannabe actresses. Some parts of the area might have, in fact, passed the tipping point. Local pornographer and breast aficionado Jay Steele says if you're at some top-drawer clubs in Miami Beach, "it's weird not to have fake breasts...." He estimates that, in such scenes, more than 80 percent of the breasts are fake.
There is an obvious explanation for our exceptional love affair with the implant: Skimpy clothes are de rigueur in our steamy clime. We're beach-oriented, body-conscious. "Why would you get them in Minnesota?" Garcia asks. "You're all wrapped up for nine months of the year."
This is true for all of Florida, of course. But Garcia adds there's another reason why Miami might be uniquely implant-friendly — even more so than Orlando, Jacksonville, or Tampa. It's the Latin factor. "Miami is part of Latin America. And in Latin America, cosmetic plastic surgery is enormously popular."
Or, says Steele, a native New Yorker, "Let's put it this way. If you live down here for two years, there's a good chance you'll have fake breasts."
Before talking about basketball-size breasts, the spike in teenage breast jobs, and the pros and cons of silicone versus saline, he first needed to explain how he got his nickname, Doctor Boobner.
"I didn't intend to do this...," said the Coral Gables plastic surgeon, whose real name is Dr. Leonard Roudner. And no, Roudner added, shaking his head emphatically: "I don't have any particular interest in breasts."
The sequence of events that catapulted the Melbourne, Australia native to Boobner status began in a Chicago hospital in October 1978. Since then, he's completed more than 10,000 jobs, breasting up celebrities, centerfolds, socialites, and porn stars. Clients have come to Coral Gables from Latin America, Europe, Asia.
It all began when Roudner, then a resident in cosmetic surgery at Cook County Hospital, attempted a new way of inserting silicone implants. Instead of making an incision under the breast, the usual method, he entered through the nipple area and under the muscle. It was a breakthrough. The benefit: minimal scars. The practice, called periareolar submuscular augmentation, now standard in the boob business, was heralded in a medical journal. (He didn't invent the process, but was among the first practitioners.)
And a few years later, after Roudner moved to Miami ("Not because it was a good plastic surgery town," he says. "I just like Miami."), he quickly gained a reputation for his then-novel technique. "I was the only one doing this at the time," he says.
The approach was particularly popular here. "Think about it," Roudner says. "Girls sunning at the beach.... When they're laying down, you could see a scar underneath their breasts. They didn't want that."
A few years ago, as the surgery became even more popular, he declared himself a virtual specialist. "I stopped doing other procedures. Maybe I'll do a tummy tuck with a breast surgery, because it makes sense," he says. "But more than 95 percent of my work is breasts."
On one typical day last month, after five surgeries and more than twenty new patient consultations, Roudner was still in his surgical scrubs. Wearing his trademark dolphin-print bandanna, he sat in his plush Coral Gables office and answered a few questions.
Can you tell fake ones from real ones?
Some women intentionally want them to look fake. They want big balls on their chest. But no, if it's well done, you really shouldn't be able to tell.
But aren't there situations — small frame, small butt, with D-size breasts — that are obviously fake?
No. You can't assume. Genetics is a funny thing. Yes, it's rare, but it happens.
What are the largest breasts you've ever implanted?
Three thousand cubic centimeters.
Can you translate that into a cup size?
The average implanted breast size is about 300 to 350 cubic centimeters. Okay? So 3000 is like a basketball. It's about money. There is this small group of exotic dancers who travel a circuit. It's like a cult. They're very weird. I don't do them anymore.
Are husbands behind many of these boob jobs?
Sure, they pressure wives or girlfriends. But sometimes they want to stop them from getting implants. I try to avoid dealing with them. I tell patients: "Husbands and boyfriends come and go. But you have to be happy with this."
What's the future for breast implants?
More and more popular. And they're getting bigger. It's competition. Some women ... say, "My friend has such-and-such a size.... I want to be bigger than her." Also we're seeing younger patients. Some girls are now asking for implants for their eighteenth birthday, instead of a new car. It's like a high school graduation gift.
Thirty-nine-year-old Gina is a Boobner alum who has had implants for nearly twenty years. At her Bal Harbour condo, before leaving for her Aspen place, she addressed one of the great mysteries of augmentation: Why would an attractive woman, blessed with perfectly nice natural breasts, need fakes?
In her case, the reason was Miami.
A native of Pensacola, she was by local standards pretty hot. Long blond hair, long legs, shapely, she was a hit on the local bikini model circuit. (She still has a box stuffed with awards from her bikini days.) "I was never insecure about my looks." And she never griped about her B-cup breasts.
But then she came south in '88 to attend the University of Miami. Here she began noticing a trend, particularly among the club/fashionista crowd on the Beach, where she worked part-time. "It was like the breasts were bigger. There were more Cs and Ds."
Gina discovered the secret of the busty Miamians: implants. And she found that, though implants were rare up north, here they were commonplace. At age 22, she went under the knife — increasing from a full B to a full C.
The newly busty Gina, who says her breasts are Halle Berry- or Elizabeth Hurley-size ("not like a stripper"), didn't receive a single sneer in the Magic City. It was like getting her hair done or buying a new skirt. People complimented her.
The larger breasts have been good to Gina. She likes the way they look, gets more attention from men, enjoys wearing low-cut clothes ("Why get implants if you're not going to use them?"), and jokes, "I never get bad service," but adds, "I get double discrimination. I'm a blond with big boobs."
And though she doesn't credit them with luring in her hubby, lawyer Howard Berlin, she admits, "They certainly didn't hurt."
Over the nearly two-decade life of her boobs, Gina's had one repair, and she's planning an upgrade. She is downright evangelical about the surgery, saying, "My girlfriends from Pensacola can't believe they're not real." She adds, "I've passed along at least ten people to Dr. Roudner. "
Pre-implants, Lynda was chubby, big-haired, not very popular with guys. Then, at the age of nineteen, she went on a dramatic diet and lost more than 50 pounds. The newly svelte young woman, though, had a problem: Her breasts disappeared. She went from a D, as a 155-pounder, to a skinny A. Worse, they were saggy; there was excess skin from her weight loss.
Lynda had never considered implants before. But as part of her image rehab, as a way to solve the saggy breasts problem, she began consulting with doctors. She visited Dr. David Rosenstein in Boynton Beach, who pointed out that, owing to her weight loss, she was an unusual case.
Although most small-breasted women would normally choose a modest increase to maintain a natural appearance, Lynda says, because of her unique situation — the excess skin, the sagginess — she needed much larger breasts.
The surgery, nine years ago, radically changed her physique: When she emerged from it, she had gone from a flat-chested A to a buxom D. "The first time my dad saw me," she recalls, "he was shocked. He wasn't happy. "
She also heard scornful comments from her Aunt Joyce, who lived in New York. "She was saying, 'What'd you do, get fake boobs?' And she was critical of women with implants."
But there were others who had a very different reaction to her new breasts. At the health club where Lynda worked, Planet Fitness in Lantana, "everyone flipped out." Most of her co-workers said, "They look great."
And then there were men. "They immediately started noticing me." Within two weeks of the surgery, Lynda says, "I had a mad-hot Brazilian boyfriend."
"I went crazy," she says, laughing at the memory of that year. "I lost 50 pounds, turned 21, and got new breasts."
Within two years — after moving to Los Angeles to work in sales for a fitness club — Lynda made a career change that literally put her implants to work. One day she responded to an ad for bikini models. It turned out to be a front for an adult filmmaker. She vowed to try it only once, "just to make a $1000." But she loved it.
During the next two years, Lynda transformed herself into Shauna Banks — adult film star and busty model. "All of my work was big-breasted. Score, Hustler, Playboy TV.
"These implants have paid for themselves over and over again."
Now, like many women who have saline implants, Lynda is planning for replacements. "They start to get saggy and soft," Lynda says, "every ten years at least."
She's going to Rosenstein ("I would only go to him!"), but this time they'll be larger. "Double Ds," she says. "I mean, I was 105 pounds when I got the Ds. Now I'm 120 pounds. So they should be bigger. And maybe when I'm 40, I'll get even bigger ones."
Then she smiles and says, "One other thing. That aunt, Joyce, the one who criticized my breasts nine years ago? She just got her own." Lynda opens a file on her computer that shows her heavy-breasted 50-year-old aunt. "Look at her," she says, admiringly. "They look great."
Jay Steele, Lynda's hubby, is a voracious consumer of breasts — and not just his wife's implanted Ds. During the past five years, he estimates he has sucked, squeezed, and fondled more than 1500 pairs of breasts. "Love them. Real ones. Fake ones," says Steele, president of the reality-porn company Steele Productions. "I don't care. I love them all."
Steele — whose work has appeared on milfseeker.com, 8thstreetlatinas.com, captainstabbin.com, roundandbrown.com, and bignaturals.com — admits he has a particular weakness for real breasts. But if they are fake, he says, he has a few preferences:
1. Symmetrical. "We've seen crooked tits," says Steele, who loads a digital photo of a muscular blond girl. The girl is naked, posing suggestively. "She's beautiful," he says, almost mournfully. "We used her but had to put a bra on her. Some of these chop shops do a horrible job," he says, shaking his head. "Why would you be cheap on your body?"
2. Silicone. After years of fondling, Steele says the verdict is clear: Silicone is better — though Lynda has saline. Silicone breasts have a softer, juicier, more realistic feel. (Note: They're more expensive, and the FDA has more stringent restrictions on silicone implants.)
3. Under the muscle. Of the two major approaches cosmetic surgeons take — under and over the muscle — Steele says, "Under the muscle is way better." He doesn't know exactly how the procedure works, but in his testing, he likes the feel. "It's more natural, softer, a better texture."
4. Big. About 50 percent of the women Steele works with have implants. The average size, he says, is probably a full D. Usually girls who implant should err on the side of larger, he says. "They're always going back to increase the size."
That said, don't try to overdo it. Even Steele — who says he can deal with almost any situation ("If the breasts aren't great, I'll just stay positive and focus on something else.") — loathes the basketball-size implants that some adult stars have. "They feel like bricks."
Mona Lee, who is to porn what Drew Rosenhaus is to football, has worked with dozens of girls during her two years as a porn talent scout for FunXXXJobs.
Her advice to younger ladies: Time your augmentation carefully.
"If you're eighteen or nineteen or even early twenties," says Lee, who finds talent for Miami-based reality pornographers such as BangBros and Icey Porn Productions, "I would say don't do it. Because if you have fake breasts, you can forget about certain jobs."
For instance, aspiring porn stars need to be conscious of their possible gigs, she says. And one staple in adult movies is "the girl next door" or "the just-turned-eighteen" — sometimes called the "barely legal" genre. That work, Lee says, pays very well. "They want 100 percent natural. No tattoos. No piercings. And natural breasts."
But this work will eventually end.
"When you turn 24, you can't fool anyone with a girl-next-door routine. Then I'd say think seriously about getting implants."
And if you're getting augmented, and you want to make more money, Lee says, think big. "Really, really big. Double Ds. There's a lot of busty work out there. They can give you a second career."
Not everyone in Miami talks unabashedly about their implants.
When Maria, a tiny, dark-haired 24-year-old, sat down one afternoon at a Coral Gables Starbucks, the encounter felt awkward — like a first date or a meeting with an undercover informant.
She wanted a pseudonym. And even in the anonymous surroundings of Starbucks on a late afternoon, with the ambient background chatter, she nearly whispered. There was a need for secrecy. "Most people don't know."
Friends, co-workers, classmates — even relatives don't know. Maria, who graduated with a degree in biology from a local college, is prepping to apply to medical school. When choosing her size, she considered her professional aspirations. "A doctor with boobs like Pamela Anderson? No way," she says, cringing at the thought.
Then why spend $5000 on a surgery no one will notice? She glanced down at the floor, growing red. "I was sick of wearing a training bra."
Maria never would have considered a boob job as a teen growing up in Miami. The daughter of a conservative Nicaraguan family, she didn't think highly of women with implants.
But Maria had an aching insecurity. She wasn't happy with her flat chest. "I thought I was late bloomer," she says. "But it never changed." So she used push-up bras to give the illusion of bustiness. Then the turning point: About two years ago, she talked with a friend at a party who openly mentioned she had fake breasts. "They looked great," Maria recalls. "They looked real." She encountered other normal, intelligent women who had been augmented."They weren't like Pamela Anderson. They were professionals."
The stereotype of the ditzy implant girl was crumbling. And a little more than a year ago, after some research, she decided to do it. "I just wanted them to look as natural as possible."
The change was small — an increase from an A to a midsize B. And because she had been using push-up bras already, her newly augmented breasts didn't really modify her appearance.
Her life hasn't changed profoundly, she says. Men didn't begin staring at her in a new way. But as Maria talks about the post-implant life changes — the one-year anniversary just passed — her voice grows steadier. "I like the way my clothes fit better.... I feel more comfortable in a bathing suit.... I feel more attractive and confident."
She didn't get implants, she says, to attract men. "It's for myself."
The goal in high-fashion modeling is to make the viewer focus on the clothes, not the breasts, says Ron Gerard, director of the Miami Beach office of elite fashion agency Next Model Management. Next, which has offices in Paris, Milan, London, and New York, is one of the world's largest agencies, providing models for high-end clients such as Ralph Lauren, Calvin Klein, and Fendi.
Although implants are commonplace in high-fashion work, Gerard, who has represented thousands of women over the past two decades, says there is still a preference in the industry for real ones. "The educated client can tell."
That said, he adds, good implants will do the job and can greatly enhance a model's marketability. A lot of girls don't want to do it, he says, but in this business, your body is your livelihood and clients are looking for a specific size. "A girl can sometimes double her income after getting implants."
The optimal bust size for an elite model these days is a full B, Gerard says. "Never a D, at biggest a full C."
A flat-chested size A (Kate Moss) or a small B is perfectly fine for high-fashion runway modeling in Paris or New York, he says. But the problem is that's too small to carry lingerie work. To show off underwear, they need larger breasts.
Gerard says the reason clients over the past five years have increasingly looked for larger breasts — the full B — is economics. It's tough times for retailers. "They don't want to pay for two models anymore," he says. "They want a girl who can do both fashion and lingerie."
After speaking with many enthusiastic implantees, New Times decided to pay an undercover visit to a randomly selected cosmetic surgeon in Miami-Dade. Initially it was a routine doctor visit: The physician came in, conducted a brief interview, inspected the patient, offered some preliminary thoughts on size and shape. There were some brief murmurs about the properties of saline, some calming words about safety and scars.
Then came the I-might-be-at-a-car-dealership part. After we were escorted into another room, a sales assistant, who was sporting implanted double Ds herself, showed some samples. Surprisingly the fake-breast catalogue was not a collection of generic, sexless, faceless models. It was a porn mag.
We were briefed on the pricing ($3500 to $6000) and financing options, and warned it would be wise to schedule an appointment early because it's busy.
Meanwhile, in an adjacent office, a thirtysomething woman with long, pulled-back hair and high heels, accompanied by her preteen daughter, was chatting with another double-D sales assistant. At one point Mom spotted a fetching set of breasts in her porn magazine. She turned to her daughter and showed her a picture, waiting for feedback. The daughter reeled in revulsion, covering her eyes.
While leaving, we encountered a group of college-age youths, also leaving a consultation. The group included two muscular guys, Abercrombie & Fitch catalogue types; and their lady friend, a chatty Latina who appeared to be about twenty years old. The girl was distressed. Her consultation did not go as planned. The doctor had balked at her request. She wanted D-size breasts, but her frame couldn't carry them. "The doctor said I'd be eating off them," she snickered to her guy friends.
This girl, however, was committed: She vowed to check with another doctor.
