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MythBusters: Is there a safe, nonsurgical breast enlargement product?

 Angela Speranza

October 5, 2009

 

I.    Introduction

II.  Methods

III.       Nuperk System

IV.        Does Nuperk Work?

V.   Brava System

VI.        Does Brava Work?

   VII.Conclusions


I. Introduction

Women are under constant pressure to fit an ideal body image that emulates feminity, sexuality, and self-confidence. Women go to great lengths to attain this self image so that they gain respect, attention, and the self esteem to stand up to the advertised image of perfection in a woman, even so far as to change their own bodies without thought of the consequences that may or may not follow. This trend for women to change their bodies to fit the cultural ideals of beauty is not a new one, for across cultures and many decades, there has been a market for beauty products to make women more attractive according to their societal ideals. From foot binding in China to lower lip extensions in Ethiopia to the corset in Western cultures, societal pressures to exaggerate female features has caused women to physically alter their body as a means to become more attractive according to their cultural standards.

 

 There has been an increasing emphasis in Western cultures on breast size and shape as a desirable, attractive quality. Women often feel self conscious about their breast size and shape and feel inadequate compared to the narrow image of beauty set as desirable in culture. An increase of breast size is thought to increase femininity, self confidence, and sensuality, and as a result, a significant percent of women have sought to surgically alter their bodies to fit the cultural view of beauty. According to the American Society of Plastic Surgeons (ASPS), there was a 921% increase of cosmetic breast augmentations done in the United States from 1992 to 2007, and in 2008 breast augmentation was the number one cosmetic surgical procedure performed on men and women (http://www.plasticsurgery.org/Media/Statistics.html). This shift shows the increasing trend for women to want to change their breast size and shape to live to the unrealistic ideal, yet because surgeries are expensive and painful, women have begun seeking alternative methods to increase their bust size.

 

There is a growing market of nonsurgical, noninvasive breast enlargement products marketed to women as all-natural, safe, and effective in increasing bust size permanently. Women may be curious to use these products, but the information available is limited. All women should evaluate the risk involved with a product versus the benefits gained. Is there a safe alternative to surgery to boost up the bust?

 

II. Methods

There are currently many different products and procedures marketed to women to safely and easily increase their breast size without surgery, including at home exercises, topical creams and lotions, herbal supplemental pills, and vacuum pumps. While all methods are marketed as successful, the two most persuasive techniques are the herbal supplements, such as the Nuperk pill system, and vacuum pumps, such as Brava, which market long term results and minimal side effects. The Nuperk pill system is said to be the number one leading brand of breast enlargement pills that offers a guarantee of results in less than three months, while the Brava system claims to be endorsed by physicians as the first clinically proven option for breast enlargement. How do both systems permanently enlarge breasts without side effects? Which system, if either, offers significant results and is safe to use?

 

III. Nuperk: What is it? How does it work? (Pill bottles, ingredients)

Text Box: “Surgery? No way! I didn't want scaring. I used Nuperk and gained the same results without the pain. In just a few months I was able to grow 2 full cup sizes. I never thought this would be possible by taking a pill. I owe all my results to Nuperk.”

To women, it may sound tempting to try a pill that promises "rounder, more perfect breasts" in less than three months and to "finally get the attention you deserve!" Nuperk offers such a guarantee that users will turn heads every time they walk into a room, and that it will naturally increase size and shape of breasts while firming tissue during use. Seem too good to be true? How does Nuperk promise such significant results? They claim that their blend of all-natural herbs promotes breast tissue growth by regulating female and growth hormones that have no negative side effects. How the ingredients combine to give such a powerful effect is left up to the interpretation of the user. The only requirements necessary for use is women any age who desire to have an increase in self-confidence and a sexier body. However, they recommend that pregnant women should not use it.

Nuperk's blend of herbs has not been evaluated by the FDA as a drug, but the ingredients in the supplement have been determined to be GRAS (Generally Regarded as Safe). Although it seems like a good deal, and the site provides many testimonies that treatment is effective, is Nuperk a safe and reliable method of breast enlargement? (http://www.nuperk.com/index.htm)

 

IV. Does Nuperk work?

Unfortunately for breast enlargement pills, there have been no evaluations on the safety or efficacy of specific herbal supplements or herbal supplements in general, nor have any prospective clinical studies been conducted. However, most breast enlargement pills contain many of the same herbal supplements that are believed to cause breast enlargement. These supplements have been evaluated individually in a study by Chalfoun, McDaniel, Motarjem, and Evans in 2004 to determine their effect on breast growth. This includes fenugreek, saw palmetto, fennel seed, wild yam, damiana, dong quai, and black cohosh. Each of them claims to have hormonal effects that stimulate breast growth, yet when their effect on the body is analyzed, there is a discrepancy in the claims.

 

Fenugreek: Claims to increase mammary size because it contains diosgenin, the precursor to progesterone in vitro. However, there has been no evidence to show that this precursor converts to progesterone in vivo. Fenugreek also shows some side effects of hypocholesterolemic, hypoglycemic, and hypolipidemic activity, so users must monitor blood sugar levels and demonstrate increased cholesterol absorption and bile acid secretion. Also, since Fenugreek shows an increase in uterine activity, pregnant women should not take it.

 

Saw Palmetto: Was initially used to increase libido and sperm count and increase breast size. Saw Palmetto blocks the enzyme 5α-reductase that converts testosterone to its active form of dihydrotestosterone (DHT), and this receptor blockage may affect estrogen levels, although no conclusive data links its effect to breast enlargement.

Fennel Seed: Research has been done on Fennel Seed's effects on rats, which upon administration, rats experienced an increase in mammary weight at moderate doses, however, no human studies have been done. So Fennel Seed cannot conclusively be linked to breast enlargement.

 

Wild Yam: Contains saponins based on diosgenin that exhibits a progesterone-like effect, yet the plant has no progesterone or estrogen in it, and although it is used in oral contraceptives there is no evidence suggesting that it stimulates breast enlargement.

 

Damiana: Used in other countries as an anti-depressant and treatment for amenorrhea, it may involve reactions with the progesterone receptors although there is no link between Damiana and breast enlargement effects.

Dong Quai: Has been used in other cultures as menstrual symptom relief due to the presence of phytoestrogens which was believed to cause gynecomastia -the increase of mammary tissue in males. Yet studies have shown evidence against its estrogenic effect, so it does not increase breast size. However, it does show anticoagualative effects and even some traces of carcinogenicity. Adverse effects to Dong Quai include photosensitivity, photodermatitis, gynecomastia, bleeding, diarrhea, and fever.

Black Cohosh: This root became publically popular for its estrogenic effects, claiming to bind to the 17β-estradiol receptors and reduce lutenizing hormone levels. However, recent clinical studies show no estrogenic effect and no changes in the lutenizing hormones, follicle stimulating hormone (FSH), prolactin, or estradiol when black cohosh is administered, so the symptomologic relief is unrelated to estrogenicity. Side effects of Black Cohosh may include a contraindication when used in conjunction with aspirins due to salicyclates in the black cohosh. It may also increase the toxicity of doxorubicin and docetaxel (both of which are used in chemotherapy).

 

From the evaluation of the components of breast enlargement pills, most of which are contained in Nuperk, there is no connection between the herbs and growth. Although some show a limited amount of hormonal effect, there has been no proof that they cause an increase in breast tissue growth and they are not without adverse events (Chalfoun et al, 2004). So to market Nuperk as all natural, safe, and effective is not based on any clear, conclusive data.

 

V. The Brava System: What is it? How does it work?

The Brava system is a vacuum pump system that uses sustained tension to stimulate cell replication of breast tissue, and after ten weeks of consistent treatment for a minimum of ten hours per day, there is an average growth of about one cup size. So the Brava system proposes an all natural, nonsurgical method for women to increase the growth of their own natural breast tissue to increase breast size, all in the privacy of their own home.

Now how exactly does sustained tension cause an increase in tissue growth? Brava claims that when cells are put under tension they will undergo "tissue expansion" where cells will replicate themselves faster to grow towards the surface where tension is supplied. By creating a three dimensional vacuum, the breast is placed under gentle, sustained tension in equal direction, so the cells begin replicating resulting in breast growth.

The Brava is consisted of a vest and two silicone domes specifically chosen based on body type to achieve the perfect breast size and shape, and a minicomputer called a Smartbox that regulates the pressure and duration of pressure. The air is sucked out of the domes to create a vacuum at a pressure regulated by the Smartbox. The ending result and tissue growth is directly correlated to the device use, so the more frequently and longer it is worn, the greater the end result.

 

It seems that the extensive wear and constant pressure would dissuade women from using the Brava system, but most women claim to use it in the evenings and overnight, and some even claim to wear is during the day under their clothes. The pressure exerted is supposedly less than the effect of gravity on the breasts.

 

According to the site, Brava is the "ideal choice" if you are a woman who wants to feel more confident and sexier about her body, who wants larger fuller breasts but can't afford surgery, has a C cup or smaller, yet must have the commitment to adhere to the strict Brava regimen. Brava is not recommended for girls still developing under eighteen, women who are pregnant or have been breast feeding within six months, women who have scar tissue on their breasts, those with chronic dermatitis, a silicone allergy, or have an irregular mammogram within a year.

(http://www.mybrava.com/home.asp)

 

So Brava seems like a strenuous but effective method to increase breast size if a woman is willing to put in the time and the money. It claims to be endorsed by physicians and clinically proven to have long term effects and no side effects, but are the studies biased? Or is the Brava system a safe and effective alternative to breast augmentation?

 

VI. Does Brava Work?

The Brava company posted its results from its studies, claiming to have found a system of breast enlargement that is considered safe, natural, and effective, but to test the efficacy of the mechanical bra system, several studies were conducted to test the results and compare to the company results.

 

In a pilot study conducted by Khouri, Schlenz, Murphy, and Baker in 2000, seventeen women between the ages of eighteen and forty were enrolled to test the system, twelve women completed the study (five dropped due to noncompliance with the study protocol) and the women were requested to wear the bra as directed on the site, at 20mmHg for 10-12 hours a day over a ten week period, and their breast size was measured on regular intervals, including baseline and post treatment MRIs, obtained in the same phase of the menstrual cycle to minimize variance. Participants were excluded if pregnant, were lactating, had a history of breast surgery, disease, trauma, or pain, or had an irregular mammogram within a year. Progress was monitored throughout treatment and thirty weeks after treatment termination, and measurements and pictures were taken at these intervals, and body weight was closely monitored. Plaster moulages of the torso were made at baseline, end of treatment, and the end of the follow up period to measure progress. In addition to breast measurements, signs of cancer were monitored, and participants also completed a self-esteem and opinion survey before and after treatment.

 

Average results from the study showed completion in 14.7 weeks at 10.4 hours a day with a significant breast volume increase of 103 +/- 35 mL or 111+/- 46 mL according to the bead displacement measurement, and histologic examination showed that the tissue grown was normal breast tissue. The MRI after treatment showed no lesions, cysts, edema, or other masses, only a proportional amount of fat and fibrogranular tissue with normal breast architecture. There were no serious adverse events such as sores or dermatological reactions attributed to the use of the device. Generally, immediately after treatment, breast size was at its maximum, with a slight recoil at the post treatment analysis. Body weight had actually decreased as breast size increased, and all women expressed satisfaction with their results as shown by their increase in self esteem as determined by pre and post surveys.

                                                           

Main concerns for safety were proven uncorrelated in the study, for normal, proportional breast tissue was grown, however in regards to concern for cancer, mechanical forces are not known to be carcinogenic. However, over the ten week treatment period and follow up period, the study showed that mechanical stimulation causes natural growth of breast tissue without serious side effects and lasting, natural looking results (Khouri et al, 2000).

 

Schlenz and Kaider conducted a similar study on a larger level in 2003 that enrolled forty women over a period ten week treatment with a follow up an average of ten months after completion of the treatment. They used the Brava system for a period of about 18.5 weeks for an average of eleven hours a day, and the average increase in breast volume was 155cc. Seventy five percent of women were satisfied, five percent acknowledged a change in breast size, and 12.5 percent were dissatisfied with their results. The study proved a direct correlation to breast growth and the extent of the system use. Breast growth, body weight, and self esteem was measured at different intervals throughout the study with an increase of an average of 4.4cm circumference of the breast, which remained constant from four weeks after treatment throughout the follow up.

In this study, women said treatment was painless with minimal side effects, including sweating, itching, and skin irritation due to the silicone rings (Schlenz&Kaider, 2007).

 

According to the studies, the Brava system is a safe, effective method of breast enlargement with lasting results and minimal side effects. Because it uses continuous, applied pressure to stimulate cell replication of breast tissue, the result is natural, non-deformed breasts on average a cup size bigger than pre-treatment. However, because of its specific physical requirements and physiologic demands on the patient, the Brava is not recommended for all women. Only women willing to devote themselves to a rigorous schedule and a time dedication to wearing the system show significant increase in breast size. There was also some mild irritation due to the silicone cups causing some discomfort. However, the company advertises results within ten weeks, whereas in reality, results are not apparent until 16-20 weeks, so some patients voiced frustration and impatience (Schlenz&Kaider, 2007). Overall, the Brava is a safe and effective alternative to surgery for women who chose to endure the rigorous treatment. Patients are screened before purchase to inform them of the risks and time involved for positive results to minimize the drop rate due to these factors

 

VII. Conclusions

Although women should feel no need to change their body to fit an image set out by society, if they wanted to seek a safe, natural, alternative method to surgery, they could feel confident in searching for the right method that will maximize results and minimize adverse side effects. Although topical creams and pills have shown no effectiveness or proven results in breast growth, mechanical tissue expansion has clinically proven results on multiple studies, giving women the option to enhance their bust but avoid the knife.

 

Bibliography

 

Brava, Breast Enhancement Shaping System. Brava, LLC, 27 Apr. 2009. Web. 1 Oct. 2009.

 

<http://www.mybrava.com/home.asp>.

 

Chalfoun, C., M.D., McDaniel, C., M.D., Motarjem, P., M.D., Evans,G.R.D., M.D. (2004).

 

          Breast Enhancing Pills: Myth and Reality. American Society of Plastic Surgeons,

 

          114(5), 1330-1333. doi:10.1097/01.PRS.0000141495.8B

 

Khouri, R. K., M.D., Schlenz, I., M.D., Murphy, B. J., M.D., Baker, T. J., M.D. (1999). 
          
          Nonsurgical Breast Enlargement Using an External Soft-Tissue Expansion System. 
 
          Annual Meeting of the American Society for Aesthetic Plastic Surgery, Dallas, TX.
 

Nuperk. Nuperk Co. Web. 01 Oct. 2009. <http://www.nuperk.com/index.htm>.

 

"Plastic Surgery Procedral Statistics." American Society of Plastic Surgeons. ASPS, 2009. Web. 01 Oct. 2009. <http://www.plasticsurgery.org/Media/Statistics.html).>.

Schlenz, I., M.D., Kaider, A., M.Sc. (2007). The Brava External Tissue Expander: Is Breast 
 
          Enlargement without Surgery a Reality?. Plastic and Reconstructive Surgery, 120(6), 
 
          1680-1689. doi:10.1097/01.prs.0000267637.43207.19
 

 

 

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