Short of surgery, can a woman enhance the size of her breasts? Many products claim it's possible, but experts say most of the claims are just padding the truth.

WebMD Feature

Reviewed By Brunilda Nazario

"We must! We must! We must increase our bust! The bigger the better, the tighter the sweater, the boys depend on us!"

While this decades-old cheer may seem silly, its message still rings true: Many women are looking for ways to enhance the size of their breasts. But other than surgery, what options are available?

From herbal pills to special creams to suctioning sports bras, experts tell WebMD what products will have you wishing you could get your money back, and which could have you filling out a larger cup size.

Herbal Pills

Bust-enhancing herbal supplements, costing about $230 for an eight-week supply, claim to increase a woman's breast size naturally, using herbs like saw palmetto, hops, wild yam, and black cohosh, according to the June 2003 issue of Obstetrics & Gynecology. While they may be au naturel, that doesn't necessarily mean they'll work.

"Buyer beware," says James Wells, MD, president of the American Society of Plastic Surgery. "I don't think any of the herbal products that are touted as breast enhancers show any promise. My challenge is for them to show some scientific evidence."

No clinical trials or animal studies on whether the alleged bust-enhancing supplements actually increase breast size have been published, according to the Obstetrics & Gynecology article. And "it is unlikely that any of these products, if they contain what their labels say that they contain, would cause breast enlargement."

Not only is it likely that herbal supplements are a waste of money, their safety is questionable as well.

According to the Obstetrics & Gynecology article, "There are no long-term safety data on any of these herbs, singly or in combination."

Breast Creams

Many breast-enhancing creams also claim to be all-natural, but like herbal supplements, that doesn't mean you're going to get a favorable result.

"Creams or lotions aren't going to work at all," says Wells, who has a private plastic surgery practice in southern California.

According to the FDA's web site, "Creams and lotions advertised as breast developers don't work, either. Some contain the hormone estrogen. Estrogen can increase breast size, but in order to be sold without a prescription these products must contain such a small amount of the hormone that its effect is insignificant."

Suction System -- Does It Work?

So, short of surgery, what might actually enhance a woman's breast? The Brava Breast Enhancement and Shaping System could be an answer.

"Brava is perfect for women who want a one-cup enhancement and are afraid of surgery," says Richard Greco, MD, who published a study on the device in the journal Plastic and Reconstructive Surgery in June 2000. "But they have to have the time and ability to wear it."

To achieve long lasting results, a woman needs to wear Brava, which costs around $2,500, for at least 10 hours a day, for a minimum of 10 weeks.

According to the Brava web site, "The System consists of two semi-rigid domes with specially engineered silicone gel rims, and a self-regulating microprocessor that creates and regulates the tension within the domes. The System is held in place by a sports-bra."

The domes gently suction the breasts, creating sustained tension and stimulating tissue growth, which is not a novel idea: Sustained tension has long been used in medicine to lengthen limbs and expand skin tissue to close a wound, according to a Brava news release.

"The average growth after 10 weeks of use is one bra-cup size," says Roger K. Khouri, MD, a plastic and reconstructive surgeon in Miami, and the inventor of Brava. "And this is real tissue growth. Just like your nose is not going to shrink with time, this doesn't shrink either."

According to the Plastic and Reconstructive Surgery report, 12 women completed a study of Brava's effectiveness and the longevity of its results. They wore the device for 10 weeks. After a four-week hiatus, the study showed the women had maintained a growth of one-cup size, on average.

Better yet, Khouri tells WebMD that the more a woman wears Brava, the more she grows, which means if she wears it for 20 weeks, instead of just 10, she could see an increase of two-cup sizes.

While there is one complication associated with Brava, it's not cancer: Brava and the concept of tissue expansion using tension are not linked to an increased risk of breast cancer, according to the Brava web site.

"We've had breast cancer experts say that of all the things women can do to their breasts, this is the safest," says Khouri.

The only complication associated with the Brava Breast Enhancement and Shaping System, Khouri says, is it may cause skin irritation where the domes meet the skin.

"We've found that by using a gentle skin cleanser before wearing Brava, and using a skin prep solution, the problem of skin irritation can be resolved," says Khouri.

Approved by the FDA for sale as a medical device, Khouri tells WebMD that more than 10,000 women have had results with this product.

The downside? A woman needs to be extremely disciplined in order to see results.

"This is not for everyone because it does require a lot of compliance, and it can be cumbersome for some women," says Greco, who is a plastic surgeon in Savannah, Ga. "If you miss one day, you need to add one week to your 10-week period."

But he does agree that it is the only alternative to surgery.

"Without surgery, it's the only product on the market that does work," says Greco, who has no financial interest in Brava.

Making the Right Choice

For most non-surgical breast enhancement products, Wells tells WebMD, "Save your money. There is no evidence that creams or supplements work."

And while the Brava system has been shown to enhance the breast, it may not be for everyone, especially those who aren't likely to stick with it.

The best way to learn more about breast enhancement is to talk with a reputable plastic surgeon who is certified by the American Board of Plastic Surgeons. He or she can help you better understand which products are for real, and which are padding the truth.

Published June 30, 2003.

SOURCES: Obstetrics & Gynecology, June 2003. Plastic and Reconstructive Surgery, June 2000. Plastic and Reconstructive Surgery June 2002. News release, Brava. Richard Greco, MD, plastic surgeon; spokesman, American Society of Plastic Surgeons, Savannah, GA. Richard K. Khouri, MD, plastic and reconstructive surgeon, inventor and medical director of Brava, Miami. James Wells, MD, president of the American Society of Plastic Surgery, Long Beach, Calif. FDA: "Do breast developers work?" www.brava.com.

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