In February 2026, former reality television star Brandi Glanville allowed a tabloid news show to film her breast implant removal surgery, commonly known as explantation or explant surgery. “I just wanted to be healthy,” she said, noting that she had been suffering from fatigue, joint pain, lumps beneath her skin, and a host of other symptoms. After the surgery, her doctor noted that one of her 20-year-old implants was leaking and the other had ruptured.  

“It is torn. It is ripped. And this is actually much worse than I had expected,” he noted, explaining that he had to change gloves mid-surgery because of the silicone leak.  

Glanville is just one of many high-profile celebrities—including Alyssa Milano, Michelle Visage, and Chrissy Teigen—who have recently discussed their decision to have an explant, reflecting the procedure’s growing popularity. In the United States, it has seen rapid growth since 2020, when data from the American Society of Plastic Surgeons (ASPS) noted a 14.9 percent decrease in breast augmentation surgery, along with a 34.4 percent increase in breast implant removal surgery. The explantation trend increased another 9 percent in 2023, and has remained consistent since.  

Despite the ban and reported complications from implants—including breast implant illness, which remains an unofficial medical diagnosis but is listed on the FDA website as a possible side effect—breast implants have remained one of the most popular cosmetic operations in the U.S. Health issues associated with breast implants are part of the trend toward explantation, but the data tell only half the story As a cultural fascination with wellness emerges in the age of the Instagram body, the recent surge in explantation also speaks to a new interplay between American social status and fashion, which has long been reflected in the size of the American breast.  

Changing body styles

Achieving the ideal breast size and shape has been crucial for centuries for those pursuing fashion trends—and body modification, including breast augmentation, often follows the fashion. Body modification is like fashion, in that it changes. Body styles move in waves and cycles. Provocative-looking styles present the female body as an object to be consumed.

And the intended consumer is often other women. Images of celebrities and style influencers “are commercialized, commodified, and monetized. So we see a shift in fashion and a shift in bodies as the mainstream absorbs trends. Rather than the augmentation of previous decades, we’re now being sold a need for body sculpting. 

In the early 20th century, the brassiere began to steadily replace the corset. The death of the corset resulted partially from steel shortages during World War I, but was also influenced by changing roles for women, who were entering the workforce in greater numbers and needed more freedom of movement than the corset allowed. However, while the smaller-breasted flapper look of the 1920s may seem less restrictive, many fashionable women invested in compressive undergarments designed to achieve the slim frame that allowed drop-waist dresses to fall straight over the torso.  

In the 1920s, too, plastic surgery became a subject of cultural fascination for Americans as advancements in surgical techniques on the battlefields of World War I opened the door to reconstructive and cosmetic surgery—including elective procedures like facelifts and rhinoplasty. In the aftermath of the war, physicians in Britain and Switzerland, in particular, pioneered skin grafting, a medical innovation that formed the foundation for advanced plastic surgery. Breasts also became a subject of interest for the burgeoning field.  

In 1922, Chicago physician Max Thorek published one of the first American accounts of breast reduction with a successful nipple reattachment. The procedure, he noted, would be ideal for “professions where perfection of form is of almost equal importance with talent, notably dancers and singers.” In his article, he cited a case involving a singer whose large breasts had interfered with her performance both “mentally and physically.” By the 1930s, treatment for “gigantomastia” was touted as a cure for what Maxwell Maltz, a best-selling author and renowned cosmetic surgeon of the day, termed the “distinct disadvantage, socially or economically,” for a woman with breasts deemed too large. 

Breasts deemed too small, however, were a more complicated problem. In the late 1890s, some surgeons experimented with paraffin injections for breast augmentation. But paraffin often migrated and became misshapen. Early attempts at augmentation through fat transfer in the 1920s and ’30s also often yielded lumpy, uneven results. Some patients showed initial satisfaction with sponges surgically inserted into the breasts, but those tended to harden over time as breast tissue fused with the sponges, making them difficult to remove.    

A surgical cure for that distress arrived in the form of silicone, a synthetic material derived from sand that comes in gel, rubber, or liquid form. It was originally developed by Corning Glass Works and Dow Chemical Company to make products like engine lubricant resistant to high temperatures—but by the mid-1950s, doctors were experimenting with silicone for prostheses to replace damaged urethras or to drain fluid during operations. While it’s unclear exactly how and when silicone began being used for breast enlargement, in 1965, a dancer at a San Francisco nightclub made headlines for her large breasts, filled with nearly a pint of silicone by a house doctor.  

The practice became an underground cottage industry; it was unregulated, expensive, and dangerous. Though the 1960s ushered in an era of beauty standards focusing on smaller proportions, like those of mod fashion icon Twiggy, and introduced significant pushback on uncomfortable undergarments like the bullet bra of the previous decade, prominent breasts were still the subject of cultural fascination. Actress Jane Fonda’s metal breastplates in the 1968 film Barbarella, for example, emphasized a larger bust and were reminiscent of the torpedo-shaped bras so popular in the 1950s. Surveys from the time show that breast insecurities didn’t dissipate even as feminists threw bras and girdles into a trash can outside the Miss America pageant in 1968 to protest the commercialized ways women were encouraged to modify their bodies.

A 1973 Psychology Today poll of 62,000 readers found that 26 percent of women were “dissatisfied” with their breasts. In 1971, the FDA declared that at least four women had died from silicone embolisms. Despite those reports, magazines like Harper’s Bazaar, Vogue, and Esquire hailed liquid silicone as a wonder drug for keeping up with the fashion, with Newsweek describing it as the injectable of choice for “jet-set sophisticates.”  

While silicone injections were never approved by the FDA, many magazines hyping injections as a miracle cure for everything from wrinkles to breast augmentation chalked the lack of official backing up to conservatism on the agency’s part, interviewing doctors who focused on the benefits. But as reports of deaths and health complications rose, it became impossible to ignore the dangers.  

In the 1980s, fashion focused on exaggeration in women’s clothing, from large shoulder pads to waists cinched with wide belts. Undergarments, like the push-up bras at Victoria’s Secret, which first opened in 1982, became a wardrobe staple. In 1988, the Wall Street Journal declared that “Breasts Are Back in Style,” noting the multimillion-dollar sales of padded bras. Though the 1990s are often remembered for waiflike looks on the runway, the “Playboy breast” had become the standard for the naked breasts featured in magazines and movies.

The Playboy look was, as Self magazine described, “amazingly round, firm, perfect breasts.” Shapewear also continued to focus on enhancement throughout the ’90s. Though the bust-enhancing Wonderbra had already existed for 30 years, the push-up bra exploded in popularity in the early ’90s, when models began wearing Wonderbras purchased in London to photo shoots. When the bra was first released in America in 1994, it was delivered to a San Francisco Macy’s by a cable car full of football cheerleaders as trumpets celebrated its arrival. 

A growing health crisis

In the three decades following the advent of the silicone breast implant, millions of patients opted for augmentation with it. And from the onset, reports of complications, including autoimmune issues, emerged. The 1995 book Informed Consent documents the long-reported and long-ignored plight of breast implant recipients who wanted to have their pain acknowledged. The book focuses on Colleen Swanson, the wife of a Dow Corning executive, who experienced pain, fatigue, hardening of the breasts, and nausea soon after she received her silicone implants in 1974. Her symptoms only worsened over the next 17 years, despite insistence from her husband’s employer that the symptoms were unrelated to her implants. Through a 1992 lawsuit, she was among the many women who won a settlement from the company. 

As the debate over the safety of breast implants began to make headlines, in 1984, breast implant recipient Maria Stern sued Dow Corning over ruptured implants she claimed had also caused extreme joint pain and chronic fatigue. Stern was awarded nearly twomillion dollars in compensatory and punitive damages. 

What followed was a wave of successful lawsuits against Dow Corning and other silicone manufacturers and a highly public congressional hearing. In February 1992, Dow Corning released a confidential internal memo acknowledging that it had known for decades that silicone gel seeped out of its implants, but the company argued that the seepage did not lead to autoimmune disorders or cancer. Following the closely scrutinized trials and hearings, the FDA banned silicone implants in 1992, a decision that was contentious in the medical community. Despite the complaints and lawsuits, many doctors continued to champion the safety of breast implants, even the newly banned silicone implants.

“From all the research data that’s been presented by competent researchers, there’s no link [between breast implants and autoimmune disorders],” Orlando plastic surgeon James Baker told the New York Times in 1992. However, there were dissenters. In the same article, Miami plastic surgeon Joan Membry explained she had seen side effects from silicone during her residency 20 years prior, noting that she had lost business because of her preference for saline implants.  

Despite the ban, silicone implants never really disappeared from the market. According to Diana Zuckerman, president of the National Center for Health Research, the ban was easily circumvented by doctors for whom breast augmentation was an easy and lucrative procedure. “For a while, there was something called a moratorium where the only women who could supposedly get silicone gel breast implants were mastectomy reconstruction patients,” Zuckerman says. “But there was a loophole for women who had any kind of abnormality in their breasts, and it was decided that an abnormality was having one breast be larger than the other. What was supposed to be a major restriction became more of an inconvenience.”  

But as the number of patients receiving saline implants increased, so did reports of complications. In 1992, the FDA received 1,200 reports of complications from saline implants, compared with 17,000 from the use of silicone that same year. The next year, the agency warned of long-term side effects of saline implants. In 2000, a study reported by the FDA found that of 901 women with saline breast implants, 21 percent needed additional surgery after three years, 16 percent had dealt with breast pain, and 5 percent experienced leakage. Despite these findings, the FDA approved saline-filled implants from two new manufacturers in the same year. 

Ultimately, the lawsuits and ban did little to diminish the popularity of breast implants. By 2006, the surgery was the number one cosmetic procedure in America, and remained at the top until 2020. The trend, according to Alan Gold, ASPS president in 2008, was likely due to “changes in fashion, i.e., décolletage-baring styles.”  

But in 2020, the decades-long fervor for large breasts began to change. That year saw a nearly 15 percent decrease in breast augmentations and a new interest in explantation. According to Cleveland-based plastic surgeon Lu-Jean Feng, one of the leading experts on illnesses related to breast implants, social media has popularized information about potential complications from breast implants that doctors have sometimes been remiss in providing.  

“In the 21st century, anecdotal information can be shared across a huge population,” Feng says. As an example, she cites the Facebook group founded by Nicole Daruda called Breast Implant Illness Research & Recovery, which she credits with coining the term “breast implant illness” to describe a host of debilitating symptoms associated with silicone breast augmentation since the 1960s, including autoimmune disorders, cancer, fatigue, brain fog, and joint pain. “That name drew the attention of many,” Feng says, pointing out that Daruda’s group initially had 500 patients when it was launched in 2015 and now has almost 80,000 members.  

(What are dense breasts? How this common condition complicates cancer detection.)

Wellness culture and the explant trend

The same social media that allows patients easy access to information about potential side effects of breast implants has also contributed to a heightened awareness of what types of bodies are in style these days. A quick scroll not only provides access to countless stories of celebrities speaking up about explantation; the heavily augmented bodies that dominated the mid-aughts are falling out of favor on feeds that now showcase a fresher look among the most fashionable. And as the trend toward minimal, so-called effortless beauty replaces more obvious amplifications, one-size-fits-all cosmetic surgery has begun to look outdated.  

Body modification is an enormous industry. We’ve traditionally seen cycles coming in with each new decade or generation […] the pared-back look is a response to the previous cycle of larger breasts, larger buttocks, and implants as part of the effects of Ozempic culture. 

Emily Kirkpatrick, a New York-based writer who focuses on the history of fashion and its place in American pop culture, calls this shift “quiet luxury,” and notes that the ability to afford constant and understated body modification has become an important indicator of social status. “Plastic surgery used to be the realm of the celebrity or hyper-wealthy,” Kirkpatrick says. “Now it’s extremely commonplace. When something becomes common, it’s no longer a standard because it has to become something exclusive, unattainable, aspirational.” Quiet luxury not only focuses on smaller bodies; it showcases the financial ability to reverse outdated cosmetic procedures like breast implants and invest in newer, natural-looking body modifications.  

In 2026, the term “wellness” has become a quiet luxury-coded catchall for products ranging from vitamins to skin creams that promise to both improve health and provide outward signifiers that their consumers have the means and are willing to invest in keeping their bodies youthful. The language of wellness has also crept into cosmetic surgery. Doctors who once merely advertised “breast implants” or “facelifts” now use the subtler indicators of quiet luxury, such as “aesthetic rejuvenation.” Instead of selling body modifications to improve appearance, the new vocabulary presents them as a means to restore health. Breasts, too, have fallen under the purview of commercialized wellness. Removing breast implants is marketed as a decision that grants women more control over their own health.

What’s more, breast lifts and fat transfer augmentation are sold as healthier alternatives to breast implants. While the current cultural ideal for breasts may be trending smaller, smaller is not synonymous with natural.