Is the Silicone Boob Job Bouncing Back?

There are certain grand historical fights that you think are over, tucked into the quaint Snoopy lunchbox of the past like a Capri Sun or bologna sandwich. Remember the Dalkon Shield I.U.D. uproar of the 1970's, with its controversial whiff of scientific profit over women's safety? Or what about the silicone-breast-implant scandals of the early 1990's? When silicone-boob-makers were all but run out of town as woman after woman came forward with ghoulish tales of ruptured implants and strange autoimmune-style ailments? Those were crazy days.

But sometimes the merry-go-round of culture swoops back around, depositing the old controversies right back in front of you like a stomping, pouty kid. Time slips back, and despite all other indications of social or at least temporal progress, the disgraced, buried past returns. Like Dick Cheney. Or creationism. Or, yes, silicone-boob jobs.

Throughout the last few months, rumors have been whipping through the breast-augmentation world that the Food and Drug Administration is on the verge of returning silicone implants to the open market after a 14-year partial ban on the gel-filled bosom enhancers. The ban, which came down in 1992, had never fully eradicated silicone -- women who had endured mastectomies or had a breast "deformity" or agreed to participate in a study could still opt for the gel -- but the average Pamela Anderson groupie, the cosmetic breast enhancer, was out of luck. She had to make do with saline.

But last summer, the F.D.A. sent word to two competing implant manufacturers, Inamed and the Mentor Corporation, that their applications to sell a new generation of silicone-filled sacs were "approvable with conditions." And since then, whispers of an imminent F.D.A. decision date -- the most recent centered on July 4 -- have regularly sifted through the country's plastic-surgery capitals, from the C-cup-loving streets of New York to the D-cup-worshipping beaches of California and Texas. (Implant size is, apparently, the one area where New Yorkers are more conservative than Texans.)

In a sign of just how confident the manufacturers are in the F.D.A.'s intentions, both Inamed and Mentor have included revenue from silicone implants in their 2006 earnings projections, CNNMoney.com reported.

"We believe that silicone will be approved," said Dr. Mark Jewell, an Oregon-based plastic surgeon and president of the American Society for Aesthetic Plastic Surgery. "I can't tell you when, but I think it will be soon."

A spokesperson for the F.D.A. declined to comment on the rumors, saying only that the applications "are still being reviewed."

Like the return of all thorny cultural controversies, the news of a potential silicone resurgence has resurrected not just the specter of the gooey sacs, but the old debate around them. And it is as toxic as ever. (And we should emphasize: This is a debate about cosmetic enhancement, not reconstructive surgery.)

In one corner -- the corner of the nip-tuckers and implant-makers -- the return of silicone has been hailed as everything from the triumph of science over "emotion" to, paradoxically, a victory for women. Cloaking themselves in the velvet mantle of women's defenders, they have touted silicone not only as safe, but, frequently, as a better product for women than saline: better-looking, better-feeling, the difference between "a zip-lock bag of Jell-o versus a zip-lock bag of water," said Dr. Jewell.

"I think that we're the advocates of women who want this operation," he continued. "These devices should be ... available for patients as choice. This is choice."

That this language skates suspiciously close to the rhetoric of the pro-choice movement makes the whole thing all the more surreal.

And enraging to women's-rights advocates.