Improving asset quality

 Sunny Sen        Print Edition: June 24, 2012

She was tall, fair and pretty, and yet she did not feel attractive. Reason: she had small breasts. So, this 25-year-old girl from New Delhi, who cannot be named, decided to take the inorganic route to gain size. With the blessings of her parents, she opted for breast augmentation surgery, a procedure through which silicon pads are inserted between the ribcage and the mammary glands to enhance the size of a woman's breasts.

Dr Ajaya Kashyap Plastic surgeon
Awareness has increased and it has come down from the upper class to the middle class: Dr Ajaya Kashyap
The family approached Dr Rashmi Taneja, Senior Consultant Plastic and Cosmetic surgeon at the Fortis Hospital in Vasant Kunj, New Delhi. After consultations, it was decided to enhance the girl's cup size from 32AA to 32C. (Breast sizes range from AA, considered small, to C, considered well endowed, to D, E, F and beyond.) The family paid Rs 1.25 lakh for the procedure. The surgery was a success and everyone was the happier for it.

It may have received some bad press of late following reports of serious defects in implants made by a French company, but breast augmentation is a booming business in India. In fact, breast surgery is the third most common aesthetic surgery procedure in the country today after rhinoplasty (nose jobs) and lipoplasty (fat removal). According to the International Society of Aesthetic Plastic Surgery (ISAPS), there were 51,000 breast augmentations in India in 2010, ranking it seventh in the world. Those procedures are estimated to have raked in Rs 600 crore to Rs 700 crore. In addition, there is a slightly smaller market for breast-lift and breastreduction procedures, which saw a total of 44,660 surgeries in 2010.

Still, India is some distance away from countries such as the United States, which saw 336,648 augmentations in 2010, and Brazil, which had 254,214. Dr Ajaya Kashyap, a plastic surgeon at Nova Specialty Surgery in Kailash Colony, New Delhi, says that when he was in the US, he performed about six such procedures in a week. It takes him two months to do as many in India. But the numbers are improving and he believes the potential here is huge. "Awareness has increased and it has come down from the upper class to the middle class," says Dr Kashyap.

Women who end up on the surgeon's table have different reasons for being there. One of Dr Kashyap's patients, a 22-year-old girl, did it to please her fiancee, though she chose not to marry him thereafter. Another surgeon says a mother got her 20-year-old daughter, a classical dancer, to go under the knife as she did not look attractive on stage with small breasts. "A woman's body is meant to be beautiful, even if it needs a couple of slits and stitches," says one woman who has opted to go in for the procedure.

The surgery itself takes just a couple of hours and the patient can get back to her routine in four days. Implants cost anywhere between Rs 40,000 and Rs 50,000, and the cost of surgery (including implants) ranges from Rs 1 lakh to Rs 1.3 lakh, depending on where it is done. Private clinics charge about 20 to 30 per cent less than large hospital chains.

While it is not uncommon for women in the West to opt for oversized breasts, Indian women prefer modest enhancements. "They want to look natural, and not very busty," says Dr Charu Sharma, a Delhi-based cosmetic surgeon who runs a clinic called Gorzeous Looks. Sharma says only 10 per cent of her patients want sizes beyond proportion. A poor diet, driven by the desire to be slim, she adds, is one of the reasons some young women have small breasts. "Such dietary habits reduce the growth of breasts." Consequently, a growing number of women under the age of 30 are looking at augmentation.


  • 1,506,475 Number of breast augmentations globally, in 2010
  • 7 India's ranking in such surgeries
  • Rs 120,00 Average price of the procedure
A few go in for a breast lift when their bodies have gone through a change after pregnancy and breast feeding. Others opt for it when age makes their breasts sag. Companies that never thought of India as a prospective business destination are beginning to recognise the opportunity here.

Johnson & Johnson's Mentor began selling implants in India two years ago and has ramped up its sales team since then. France's EuroSilicone is another company that sells implants in India. Raghu Kumar, MD of Allergan India, says that while the company does not sell implants directly, it has a distribution channel.

Augmentation surgery has had its share of controversy, with the biggest criticism being that it heightened breast cancer risks. Over the years, various studies have tried to debunk this. In India, many doctors use US FDA (Food and Drug Administration) approved implants made by companies such as Mentor and Allergan.

"The silicon gel has gone through many changes," says Dr Taneja. "The new gel is cohesive, and the chances of it bleeding are not there." The industry's reputation took a hit after it emerged that French company Poly Implant Prothese (PIP) had been manufacturing defective implants. In December 2011, the French government advised 30,000 women to have implants made by PIP removed. It stated that the implants had an unusually high rupture rate and possibly contained industrialgrade silicon. Over the previous decade, hundreds of thousands of women around the world had been implanted with PIP'S dodgy product.

In 1998, Dow Corning agreed to pay $3.2 billion to settle claims by more than 170,000 women that its implants had harmed their health. Apart from implant quality, the surgeon's skill is also important. One woman made headlines in the US after claiming that a botched operation left her breasts joined together, leaving her with one large breast. Another botched surgery left Hollywood actress Tara Reid with a deformed nipple.

All else being normal, if it is done right and there are no defects in the implants, a woman can lead a normal life with augmented breasts - she can have babies and even breast feed. Assuming, that is, that she needed to have such a procedure in the first place.

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