01/20/2012 08:00 am ET Updated May 16, 2012

Keeping Abreast of Breasts

No part of a woman's body is more iconic and multi-tasking than her breasts. They're utilitarian silos for babies and objects of desire for lovers. They're public, "out there," and on display no matter what their size. They're a source of pride, shame, obsession, and seduction.

That said, you'd think that by the time we hit our 50s we'd have made peace with our breasts. Not so. Breast augmentation is on the rise among all age groups and so are its risks. The latest scandal involving faulty breast implants manufactured by the French company Poly Implants Protheses simply underscores this reality.

Certain cultural ironies come to mind here. The U.S. and Britain are by far the largest consumers of breast implants in the world. France, however, is one western country that's not particularly obsessed with super-sized breasts. Though the symbol of the French Republic is the bare-breasted Marianne depicted most famously in Delacroix's "Liberty Leading the People," it seems that most French breasts are small enough to fit into the rim of a champagne glass. Take note, for example, of all the topless French women on beaches. Less is more in France. And if you have more, keep it to yourself. Other non-western cultures don't fetishize breasts the way we do, though they've certainly seemed keen on other parts of the body. (Foot binding, anyone?)

Culture, of course, shapes everything, including our breasts. Pamela Anderson's "endowment" set a standard for what's become something of a norm these days. Bay Watch could just as well have been called Boob Watch. There's no denying that the commercialization of soft porn has had a huge impact on the sexualization of American culture and women's sense of body image, young and old alike, whether implants are coveted for medical or cosmetic reasons.

It wasn't always like this. Decades ago, when breast implants weren't as pervasive as Botox, women burned their bras and exalted in a sense of ownership of their bodies. Poet Deena Metzger most famously epitomized that sense of exaltation and empowerment when she posed for the now iconic "Breast Cancer Warrior" poster : Her arms lifted joyfully, one breast intact, the other breast removed post- mastectomy and replaced with a sinewy tattoo.

"The great gift of the poster was that it saved many, many, many women's lives who saw that they didn't have to have implants in order to enjoy life," Metzger said in an email. "We didn't know how very lethal silicone implants were at the time -- now we do -- but the crisis keeps coming up again... What I found is that what breasts are supposed to mean in the culture isn't necessarily true, and you have to distinguish between what the media and advertisers say and what people say... Commercial interests, beauty and health do not get along. It's hype out there."

Indeed hype abounds, but even when less of a commercial infrastructure existed to sell hype, women and girls fretted over their breasts. Back in the late 1800's and early 1900's, paraffin, animal fat, ivory, glass balls and ground rubber were just a few of the fillers injected into their chests to get a rise. The advent of medical technology and cosmetic surgery is simply the latest manifestation of an obsession that's haunted humanity for centuries, if not millennia.

Countless books have been written on the subject, but there's probably none more exhaustive than Marilyn Yalom's "History of the Breast." Yalom explores 25,000 years worth of breast history (if such a term exists) going all the way back to Paleolithic goddesses and bare-breasted snake priestesses. One of the many things she addresses is the dichotomy between being a mother and being a lover. As she puts it, the "sacred and sexual aspects represent two different tugs at the breast. The mandate to nurse and the mandate to titillate are competing claims that continue to shape women's fate." That's a nice way of saying that women have been negotiating the dicey terrain between the Madonna and the Whore forever.

Wet nurses might be a thing of the past, but the desire to keep our breasts aesthetically intact as we age and become parents -- that "tug" -- does not go away. The difference now is that young women barely past girlhood and well before their prime are turning to cosmetic intervention.

"I think we scorn younger women in their 20s for getting cosmetic surgery and Botox," a fifty year-old friend recently said to me. "At least when we're 40 or 50, there's a feeling that we've earned the right to do what we want with our bodies, even if, ironically, that means trying to look like we did when we were 20 or 30."

To what extent does gender play a role in this? "Men wrote to me almost as much as women and thanked me," Metzger added. "They said that the poster told them they could be with and love a woman who is one-breasted. And as they had as great a chance of ending up being with a woman with breast cancer as she had of having breast cancer, they were grateful. In working with women who have just discovered they have breast cancer, I don't know of a single case where the man says, get an implant or have reconstruction. It's the woman who is afraid. I didn't have any trouble with men -- I was a single woman when I had cancer -- and later married a very handsome man 20 years younger than me. That was in the 80s."

Times change. And yet. If eyes are windows to our soul, then breasts are still gateways to our anxieties and fantasies about womanhood. In the Age of Viagra, the stakes are high for both genders. Just how high those stakes will rise is anyone's guess.