If she's not blessed with them by birth, implant surgery is really the only thing that can give a woman those high, full, finn breasts our culture so adores. Breast augmentation surgery, which first became available in the early 1960s, involves implanting a half-moon-shaped envelope of silicone or polyurethane, filled with silicone gel or saline solution, directly into the breast. The implant is slipped through a small incision made at the crease along the underside of the breast and normally leaves only a tiny scar. Over a million American women have had breast implants, 80 percent of them for cosmetic reasons and the rest to restore breasts damaged by cancer surgery.

Even so, in recent years an increasing number of questions have been raised about the long-term safety of breast implants. Some medical studies have sug¬gested that the silicone gel may leak out ofthe envelope and migrate to other parts of the body, causing pain, infections and a hardening of skin and tissue called scleroderma, and perhaps increasing the risk of autoimmune disorders. Silicone and some of its breakdown products have been shown to cause cancer in lab animals (although - at least so fqr- there's no convincing evidence that it causes cancer in humans).

There's also a concern that implants may make early detection of breast cancer more difficult by interfering with mammograms. The American College of Radiology recently issued a consensus statement that "women contemplating augmentation be informed that mammography may be more difficult to perform and may be less effective." (Other radiologists dispute this claim, but the contrer versy lingers.)

Many of these long-simmering claims and questions came to a head in 1992, when the Food and Drug Administration (FDA) reviewed mountains of data on the safety of implants. (Implants first came on the market before the FDA was given authority to regulate medical devices; this was the first time a sweeping review of the data had been conducted.) FDA scientists concluded two things. First, although the evidence was sketchy and inconclusive, there were enough reports of health problems associated with implants to be worrisome. And second, there simply were not enough hard scientific data to conclude that they were completely safe. As a result, the FDA has called a moratorium on selling and implanting the devices until further studies can be conducted.

So for now, at least, that's one option that won't be available to most women. If you already have breast implants and they're giving you no trouble, there's no reason to have them removed, stresses FDA Commissioner David A. Kessler, M.D. But women who are troubled by symptoms they suspect are related to their implants (such as joint pain, muscle pain or fatigue) should not hesitate to see their doctor.