The inaugural season of Allure Perspectives will explore one of the most controversial and medically researched parts of a woman’s body: breasts. Through expert interviews, personal stories, and historical context, the podcast series, hosted by editor in chief Jessica Cruel, will examine how breasts intersect with beauty, health, identity, sexuality, and culture. In our fourth episode, Cruel talks with Beverly Hills-based plastic surgeon Lisa Cassileth, MD, about how GLP-1 drugs are changing breast surgeries, advances in implant technology, how AI chatbots are changing consultations, and more on the biggest boob job trends. Subscribe wherever you get your podcasts for new episodes every week.
Lisa Cassileth, MD, the first female chief of plastic surgery at Cedars-Sinai Medical Center and a renowned plastic surgeon in Beverly Hills, says sentiments around breast implants tend to ping-pong between fear and excitement.
Fear tends to bubble up when stories about breast implant-associated ALCL (anaplastic large cell lymphoma) are circulating. “People hear about it, and they’re afraid, and so everyone starts to remove their implant,” Dr. Cassileth says. “Then, suddenly, Kylie Jenner gets a breast aug with 445 CCs and everyone’s like, ‘I want a breast aug with 445 CCs.’ The pendulum swings. We’ve gone through now, in my career, the third cycle of removal and excitement.”
Right now, we’re in a period of excitement, and Dr. Cassileth—known for her ability to fix botched boob jobs, her minimally invasive post-mastectomy reconstructions, and her focus on patient outcomes—has a front-row seat to it all. In the fourth episode of Perspectives, she shares stories about how GLP-1 drugs, artificial intelligence, and new advances in implant technology are changing patient outcomes.
On how GLP-1 medication has changed breast lifts
The rise in the number of patients taking a GLP-1 drug—like Wegovy or Zepbound—is bringing people to Dr. Cassileth’s office. “[Patients] are losing 20, 30 pounds,” she says. “And it’s hitting them in the breast.”
The types of procedures have changed too. The number of requests she gets for breast reductions has gone down, while lifts are on the rise. After extreme weight loss, a patient’s breasts might be the size they want, “but [the volume] is in the wrong place,” Dr. Cassileth says. “You’ll have no breast [tissue] on the upper half and all the breast [tissue] is on the lower half.”
She explains that this is caused by excess, lax skin, which has also affected the actual technique she uses for these lifts. “The lifts used to rely on the skin being tightened,” Dr. Cassileth says. But “If you have skin that’s been stretched out… why would we rely on that skin? It’s already failed.”
Luckily, there have been technological advances in the form of absorbable mesh that can assist where the skin might not be able to. “The mesh holds the breast in position, but over time it dissolves and leaves scar tissue and collagen tissue where the body is replacing the mesh,” Dr. Cassileth says. This, she says, also allows her to create whatever shape the patient wants.
On the “ballerina boob” and “yoga boob” trend
Like everything else in beauty, there are trends in breast shape. Right now, small, perky boobs are in, Dr. Cassileth says. Two types she says patients ask for by name are the ballerina boob (“a tiny bit of tissue just under the areola”) and the yoga boob (“a scoop with a droop,” basically avoiding any fullness at the top of the breast).
Dr. Cassileth says these won’t look natural on many people’s bodies, which she tries to explain during the consultation. “That size on you may not look like that size does on a celebrity or someone else,” she tells patients.
