If all goes well, Akinyi Okoth, a single, 32-year-old Manhattan woman, will come home from a lengthy vacation later this summer with the breasts she has long wanted.
Like a quarter of a million U.S. women each year, Okoth plans to have her breasts enlarged with implants. She's always felt unfairly shortchanged when it comes to her breast size, she says, pointing out that her sisters are well-endowed. Besides, she thinks clothes look better on bustier women.
"I feel good about myself, but I think breast implants will make me look better and change the way I think and act," says the information technology professional.
The Food and Drug Administration may still be considering whether silicone gel implants -- like saline implants -- are safe for general use in augmentation, but for Okoth, it's a moot point. She's made up her mind to obtain what nature itself didn't create.
Her determination underscores a point that has often been overlooked in the debate over the safety of silicone implants, pulled from the market 13 years ago: U.S. women want augmentation, silicone or no silicone.
Even as public health officials, breast manufacturers and anti-implant activists have been warring over the risks of silicone implants, more women than ever are paying the price -- and taking the risk -- to have perkier or bigger breasts.
Sometimes the changes are subtle, noticed primarily by the woman herself. Often they're obvious, meant to be noticed by almost everyone. In any case, augmentation no longer carries the stigma it once had.
In 1992, the year silicone implants were banned for general use, an estimated 32,607 women underwent augmentation -- elective surgery to enhance breast size. Since then, augmentations have soared to an estimated 252,915 a year, according to the American Society of Plastic Surgeons.
"Breasts sell," said Ann Kearney-Cooke, a Cincinnati psychologist who has studied body image. "Whenever you have a body part that there is such a high charge around in the culture, I think that is when you see people getting obsessed and dissatisfied."
In part, the popularity of augmentation surgery can be traced to the growing overall acceptance of plastic surgery. Cosmetic procedures have increased 26% since 2000, the plastic surgeons group says.
"The whole idea of remodeling your body has become a fashion statement, almost like changing your wardrobe," says Rita Freedman, a clinical psychologist in Harrison, N.Y., who has studied body image and breast implants.
