The Great Boob Bust

The sagging economy has triggered a sharp decline in the number of women getting breast implants. Maura Moynihan on why a smaller cup size is good for America.

Is there a causal pathway linking the simultaneous collapse of Wall Street, the Republican Party, and the porn boob? Plastic surgery, last year's growth industry, has shrunk as fast as News Corp. stock.

The coverage in the downturn of plastic surgery is filled with alarm and concern over falling profits. Doctors speak of turning business around; it's just a temporary drop in consumer confidence; when people get back on their financial feet, they'll be coming in for nips and tucks.

I have yet to read an article anywhere that suggests that a reallocation of income, from boob jobs to, say, food, might be a return to sanity.

A reallocation of income, from boob jobs to, say, food, might be a return to sanity.

In the Bush years, the plastic surgery bubble seemed a sure sign of madness bound to burst. Parents purchasing breast implants for their teenage daughters, husbands buying surgery gift cards for their wives, actresses and models documenting hospital pilgrimages on TV, boob blogs. Rear ends were lifted while Iraq burned, the deficit soared, and the polar ice caps melted.

Americans have the lowest rate of savings of any populace in the developed world, hovering around zero percent. Yet the American Society of Plastic Surgeons reported in 2007 that American consumers spent more than $12 billion on cosmetic surgery.

But now the society reports a 62 percent overall decrease in cosmetic surgery from 2007 to 2008. Business has plunged in regions with the largest home foreclosures, from Florida to Southern California. Forget about Ohio. Until the financial crisis hit, the theory and practice of cosmetic surgery encountered virtually no impediments from medical or mental health professionals, or media enablers.

The most popular cosmetic surgical procedure in the United States is the boob job. It’s as American as a football cheerleader. The American Society of Plastic Surgeons reports that the number of breast augmentations in the US increased 657 percent from 1992 to 2003. There is a difference between a padded bra and silicone implants—the padded bra can be safely removed after it has served its purpose; the "porn boob" has rendered the bra meretricious, obsolete. As I recall, it all started in the '80s.

In that decade, Ronald Reagan's new conservatives attacked abortion clinics, crushed the Equal Rights Amendment, and sought to restore the traditional subordination of women within the patriarchy. In the 1980s nude models began brazenly to display "porn boobs"—grotesquely swollen, enlarged breasts, instant triggers of pre-Viagra era male lust. Model and talent agencies advised hopeful ingénues to get implants, to achieve the "Barbie Body." The solution to female physical inadequacy provided by the medical/scientific/engineering establishment, the supreme authority in our industrial society, was achieved by surgical alteration as a means to salvation, by the omnipotent, omniscient man in the white coat wielding a knife, who would to transform the flesh to deliver the soul to safety and power, and, yes, yes, yes, love.

I've watched in puzzlement as friends and neighbors, women with advanced degrees, stock portfolios, great legs and hair, women one assumed had transcended much anxiety and fear about sexual appeal and self-esteem, using discretionary income or taking out bank loans to get breast implants, tummy tucks, and eye lifts. After enduring the excruciating pain of surgery and a long and perilous recovery period, the results are often strange and painful, and too often there are complications, illness, and even disfigurement.

For 20 years, the medical establishment and the pharmaceutical industry vigorously promoted plastic surgery. Most of the messaging, most websites, most information comes directly from the medical businesses, following the familiar arc of marketing of other pharmaceutical products. Advertising notably conceals the medical risks involved; for example, that any person with a medical degree, regardless of or even without special training, is legally permitted to perform cosmetic surgery.

It is something of a crime that young doctors meet great impediments to practicing health care and incur great expenses to attend medical school, and when they open a practice endure harassment from lawyers and insurers, but face fewer impediments to applying their skills and education to plastic surgery. Because it is elective, it is beyond the scope of medical insurers. Breast implants can be obtained with zero percent financing, like a new car.

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Plastic surgery is elective, marketed as a "lifestyle product," which sold the myth of "safe surgery."On sites like, women who have become ill or disfigured by surgery confess to feeling duped, misled, and encouraged to have the surgery. So what made them do it? From whence came this urgent need for the Barbie Body?

I opened up an old copy of the classic work by the late John Kenneth Galbraith, The Affluent Society, which challenged the classical economic theory of "consumer sovereignty." Galbraith noted that it is not consumers who are sovereign, but rather the gigantic firms that produce and market goods and services. To quote the good professor: "The creation of artificial wants through advertising and the propensity for emulation shifts resources toward private goods and away from public goods that have greater inherent value. New automobiles are seen as being more important than new roads; vacuum cleaners in the home are desired more than street cleaners. Alcohol, comic books, and mouthwashes take on a greater aggregate importance than schools, courts, and municipal swimming pools."

Now the market for Hummers, mortgages, and porn boobs is collapsing, all at once. So can we get zero percent financing for things we really need, like root canals and annual checkups?

Maura Moynihan is the founding director of Friends of Moynihan Station. She lives in New York City.