Doctors and even opponents of silicone breast implants predict there'll be a boom in the bust-augmentation business now that the U.S. Food and Drug Administration has ended a 14-year virtual ban on the use of the silicone gel implants.

Dr. T. Roderick Hester, chief of plastic surgery at Emory University and a doctor at Paces Plastic Surgery Group, said Monday that he expects more women to seek breast augmentation now that silicone is again available. Silicone has been found to be safer, more effective and more natural-looking than saline implants, which tend to deflate.

Since silicone was banned amid health concerns in 1992, it has been available only for mastectomy patients who needed breast reconstruction and in some other special cases. Saline implants have been sold without restriction during that time, but women seeking surgery for cosmetic purposes could get silicone only by participating in FDA-approved studies.

Julie Berryman of Smyrna took part in one of those studies. She's so happy with her silicone-gel-enhanced breasts that she now buys bikinis and tight-fitting sweaters she wistfully left behind on clothing store shelves last spring — when her bra size was a mere 34B.

Now the 30-year-old nurse wears a much fuller size 34C and says she loves her body and enjoys shopping a lot more than she did before her breast-augmentation surgery.

Hester and other plastic surgeons say breast-augmentation surgery is big in Atlanta, as it is in most affluent metro areas.

Plastic surgeons nationwide performed 291,000 augmentations last year, a 37 percent increase from 2000. Another 58,000 women had breast reconstructions.

Berryman was a member of the small minority of those — 10 percent to 15 percent annually — whose enlargements were done with silicone.

While plastic surgeons hailed the FDA's move last week, consumer advocacy groups like the National Women's Health Network maintained their position that silicone gel is dangerous.

Plastic surgeons like Hester disagree.

"After a long time, it's become apparent that silicone is not a poison, it's not toxic, and there's no evidence it makes women get sick," he said. His practice was one of those allowed to keep using silicone gel after the FDA's ban, and he said he's had no problems.

"In my experience, when women have the choice, over 90 percent choose silicone gel," he said. "Most plastic surgeons prefer it. I do about 100 augmentations a year, almost all with silicone."

Dr. Miles H. Graivier, a plastic surgeon in Roswell, said most of the implants he's done since 1992 have been saline and he's performed 160 operations so far this year.

"I think it's going to change fairly dramatically now to silicone gel, because that's what people have been asking for," he said. Since 1992, "women would come in and ask if silicone was available, but if they didn't meet the FDA's study protocol, it had to be saline. Now it's going to be a lot more silicone."

He said most breast augmentations cost between $4,500 and $6,500.

But some groups insist the FDA is wrong to lift the ban. Diana Zuckerman, president of the Washington-based National Research Center for Women and Families, said she was surprised and upset at the FDA's change of mind.

"They wouldn't have had a requirement of studies [of silicone use] if they thought it was completely safe," she said. "There was a time when women making this decision were flat-chested and wanted to look like other women. Now there's a lot of encouragement of women who look perfectly fine already but want to supersize.

"It's a phenomenon that has very little to do with how women look but how they think they ought to look, which they get from the thin actresses with large breasts on TV and in movies," she said. She said both silicone and saline implants often leak over the years and can cause health problems.

Proponents like Berryman and many plastic surgeons contend that silicone looks and feels more natural than saline implants, which are sold without restrictions. Allergan and Mentor, both California companies, have gotten the OK to resume general sales of silicone implants.

Dr. Rita Freeman, a clinical psychologist in Harrison, N.Y., and author of several books on how women see their bodies, said the "pursuit of beauty with implants both increases and decreases a woman's sense of well-being. An implanted breast may reduce self-consciousness and may produce attention, but it's costly, it doesn't feel natural, and it may impair the nursing of children."

She said she served on the FDA panel that ruled against silicone implants in 1992.

"We have a tremendous investment in mammaries in this country," she said. "We are called mammals because of that distinguishing characteristic. We forget the fact that breasts have a natural function."

Zuckerman said implants "interfere with mammograms, showing up as a big white shape so that you can't see cancerous tumors. We believe the appeal [of implants] is an indication of how unhappy women are with their bodies; that they think they'll be happier with bigger breasts."

NPD Group, a market research firm in New York that collects data for the largest bra manufacturers, said the most popular size through September 2006 was 36C, which has held steady for two years. In 1991, the most common bra switched from 34B to 36C, NPD said.

Another group disappointed by the FDA's ruling was Public Citizen, which has opposed the use of silicone implants since 1988.

Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, said the FDA's action "raises again the larger issue of the poor leadership and dangerously poor performance" of the federal agency. He said he'll urge "thorough congressional investigations and hearings on this lack of assertion of regulatory authority" by the FDA.

In the meantime, Berryman is sold on silicone.

"One of my breasts was larger than the other," she said. "Now I'm happy with them. People really notice. And my boyfriend likes them, too."