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Friday, August 22, 2014

SALINE INJECTION: TEMPORARY BREAST ENLARGEMENT

Amanda Sanders showing results of an injection of saline solution to temporarily enlarge her breasts,
a quick fix that some doctors do not approve of.
Before a romantic Caribbean weekend with her new boyfriend, Amanda Sanders decided she needed a little lift. So she called her doctor, Dr. Norman M. Rowe, to help out.

Dr. Rowe, a plastic surgeon in Manhattan, offers a quick fix — temporary breast enlargement. Instead of surgery, he injects a saline solution into the breasts, which briefly expands them.

The procedure began as as a way for women seeking breast enhancement to determine how they might look if they chose surgery. “We can take pictures and put them on computers, but those are sometimes unrealistic and can lead to false expectations,” Dr. Rowe said (giving new meaning, perhaps, to the term “falsies”). “So we said, if patients are unsure if they want implants, let’s put saline in the breast and let them live with it for 24 hours to see how they like it.”

It may not surprise that the injections were soon being requested as pick-me-ups for parties, weddings, bar mitzvahs, red-carpet events or, as with Ms. Sanders, a tropical vacation.

Ms. Sanders, 41, an image consultant in New York and a mother of two, had been toying with the idea of a breast lift to enhance her “very shallow C cup,” but she was a little reluctant. When she heard of the temporary saline option (cost: $3,500), she leapt at the chance. Twice.

“It was worth it,” she said. “I could wear halter tops and a string bikini and feel really sexy. I’m in the business of vanity. As an image consultant, I have to look the part and be the part.”

While “lunchtime lifts” using injectable fillers similar to Restylane or JuvĂ©derm are available in Europe, they are not F.D.A.-approved in the United States. Macrolane, another filler, was banned in Britain as a breast injectable because it was thought to cloud mammogram readings, among other complications. Saline is essentially saltwater that is absorbed into the bloodstream in about 24 hours.

Breast enhancement surgeries are decidedly popular in the United States. According to the American Society for Aesthetic Plastic Surgery, 313,327 breast augmentations and 137,233 breast lifts were performed in 2013. A noninvasive procedure like a saline injection would seem to be just what the doctor ordered.

But not every doctor. Few seem to condone the injections, which Dr. Rowe has been doing for about five years for presurgical patients. Over the last year, he has been flooded with requests for one-night use. He does three to five procedures a week, he said, with minor bruising the only complication.

Dr. Michael C. Edwards, a plastic surgeon in Las Vegas and the president of American Society for Aesthetic Plastic Surgery, called the practice “a party trick.”

“I can’t see that there’s a huge harm in it, but you’re stretching the skin out,” he said. “You’re altering the architecture of the breast. I would be concerned that you would be taking away some intrinsic support in the breast.”

Dr. Steven Teitelbaum, a plastic surgeon in Santa Monica, Calif., and an associate clinical professor of plastic surgery at the U.C.L.A. School of Medicine, called the saline solution unnecessary. “Between good bras and chicken cutlets, you can always look good in clothes,” he said.

As for its use in gauging implant size, he added: “The feel of saline is sharply dissimilar from an implant, and the appearance is different because the edges diffuse and feather, which an implant does not.” Three-dimensional imaging, which has become a viable option for projecting surgical outcomes, would be a more accurate prediction of size and shape, he said. (Indeed, a recent study published in the Aesthetic Surgery Journal found that 3-D imaging was more than 90 percent accurate in predicting postoperative breast volume and surface contour.)

Dr. Jennifer Capla, a plastic surgeon in New York, offers saline injections as part of her $450 consultation for breast augmentation surgery. “If done by a board-certified plastic surgeon in a fashion that’s safe, I think it’s O.K.,” she said. “But is it safe to do three days in a row? Will it cause electrolyte imbalance? I’m a big fan of moderation.”

Courtney Daal, 27, of Brooklyn was married in June. Before her wedding, she paid a visit to Dr. Rowe. “I wanted to not be too enhanced but look my best,” said Ms. Daal, who went from an A cup to a C cup for the big day. To be sure her custom strapless gown would fit over her new additions, she advised her seamstress in advance, so she could plan accordingly.

Like Cinderella after midnight, her breasts returned to their natural state some 24 hours later. Still, it was enough time for the groom to notice: “He asked me if I was wearing something, and I said, ‘No, it’s all me!’ ”

As for Ms. Sanders, she didn’t tell her boyfriend where her extra padding came from. “But he was certainly very happy,” she said.

Alas, like her saline injections, the relationship was short-lived. The couple broke up soon after their trip.

By ABBY ELLIN
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http://mobile.nytimes.com/2014/08/21/fashion/what-a-difference-a-day-makes.html?referrer=

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