The Surgeon Minute

Beauty and the Breast

Beauty and the Breast

Where is beauty if not in the eye of the beholder? Can we see beauty in ourselves? How clearly?

Over 250 women’s voices were heard for a yet unpublished study that may bring into focus some issues associated with Breast Augmentation.

By: James D. Namnoum, MD
and Chris Knisley

Dr. James Namnoum, a Johns Hopkins graduate and expert in cosmetic and reconstructive breast surgery, understands the importance and impact of a large-scale study such as this. Plastic surgeons must, first and foremost, understand the perspective of their patients.


“Communication is essential for everything in life but, in particular, it’s essential when talking to women about their goals with breast augmentation.”

The way that we see ourselves is decidedly different from the way that others see us. In the same fashion, we see ourselves in one way alone and another way when juxtaposed with what is considered ideal. Even then, women and surgeons may have different opinions about what that is!


It is the plastic surgeon’s job to manage all of these various, competing perceptions. They must serve as both translator and architect.

Doctors often speak in languages that sound foreign, despite all the words being in English. But, computer imaging is allowing surgeons to break through the language barrier — there is no mincing of words when it comes to pictures.

Real & Unreal

Women typically enter the plastic surgeon’s office with one word in mind: Natural.

Once past the initial consultation, Dr. Namnoum moves with patients to the digital imaging stage. It is here that he finds discord between what patients say they want and the pictures that they select. At the pictorial level, women appear to gravitate towards larger implants than surgeons would predict.

wp1Dr. Namnoum recognizes a sweet spot that exists between size and shape that implies women’s desire to augment as much as possible while maintaining that air of mystery in the eye of their beholders. Real or Unreal?


Images of large-breasted women pervade cultural media. Procedures are increasingly chosen that provide the look of a push-up bra without the push-up bra.

Marketing and Celebrities have continued to raise the bar of expectations. Beauty is a moving target and it’s moving up. Modern perceptions of Beauty are increasingly about sexuality rather than innocence.

No matter what culture says, it is the plastic surgeon’s job to ensure maximum and open communication with patients. It is the goal of studies like these to redirect focus on the desires of women. While there may be overall tendencies, each woman is unique in her perspective and body, and requires the attention of a well-informed, open-minded surgeon.

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