It was in 1962 that Timmie Jean Lindsey was offered a solution to a non-existent problem. A factory worker from Texas, she had married at 15, had six children, divorced in her mid-20s, and taken up with a man who encouraged her to have a vine tattooed on her cleavage. Roses tumbled across her breasts. When the relationship faltered, Lindsey decided she wanted the tattoos removed. "I was ashamed," she says, "and I needed them taken off." Her low-paid work made her eligible for treatment at a charity hospital, where she was told the tattoo could be removed through dermabrasion. And the doctors had another proposal. Had she ever thought about breast implants?

Lindsey had not. She'd never felt self-conscious about her breasts – and even if she had, the options at that time were primitive and problematic, involving substances injected directly into women's chests, or implants made of sponge. "The only person I'd ever talked to about breast implants was my cousin," says Lindsey, "who had had some kind of surgery. She said: 'Sometimes I wake up and my breast has moved to another part of my body,' and I thought: 'My God. I never want that.' It wasn't long after she and I talked that I came into contact with these doctors."

The team was led by Dr Thomas Cronin, who had been developing the world's first silicone breast implants. Thomas Biggs, then 29, and a surgical resident under Cronin, says the idea came about when one of his colleagues, Frank Gerow, went to the blood bank. "They'd stopped putting liquids in glass bottles, and begun putting them into plastic bags," says Biggs, "and he was walking in the hall with this bag of blood, and felt that it had the softness of a breast." Around the same time, Cronin travelled "to New Orleans to a plastic surgery meeting and encountered a former resident of his. This fellow told him there was a company who had a new product which was interesting because it had very little body reaction, and could be made into a variety of thicknesses, a variety of viscosities, all the way from liquid to solid. If you can make a solid, you can make a bag – and if you can make a liquid, you can make something that goes in it."

Cronin had the idea for a breast implant. A prototype was created, and implanted into a dog called Esmeralda. "That worked OK," says Biggs, "and so then they got to Timmie Lindsey." After spending some time with the doctors, she says, "they asked me if I wanted implants, and I said: 'Well, I don't really know.' The only thing I'd ever thought about changing was my ears. I told them I'd rather have my ears fixed than to have new breasts, and they said, well, they'd fix that too. So I said, OK. When they put the implants in they said: 'Do you want to see them?' and I said: 'No, I don't want to look at it. You put it in me, and it'll be out of sight, out of mind. My theory was that if you think you've got something foreign inside you you're just going to worry about it." She's 80 today, still living in Texas, working night shifts in a care home, and those first, experimental globes remain in her chest.

The 50-year history of breast implants had begun, a history of controversy and success. What no one knew back then was just how phenomenally popular breast augmentation surgery would become – the last available figures from the American Society for Aesthetic Plastic Surgery show it was the most popular form of cosmetic surgery in the US in 2010, with 318,123 augmentations performed. It is also the most popular cosmetic operation in the UK. While there are no overall figures for cosmetic surgery here, those collected by the British Association of Aesthetic Plastic Surgeons (BAAPS), which represent around a third of the market, show 9,418 women had breast augmentation in 2010, a rise of more than 10% from the previous year.

It's estimated between 5 and 10 million women worldwide have had the surgery, many for cosmetic reasons, and a significant proportion for reconstruction following a mastectomy, or for transsexual people transitioning from male to female. But concern around them has never abated, with the most recent row being one of the most disturbing, and vexed. In 2010, after concerns about ruptures in implants made by French company Poly Implant Prosthesis (PIP), it emerged the company had been filling them not with the medical-grade silicone that had won them a CE mark, and the right to sell them in Europe – but industrial-grade silicone, otherwise used to make mattresses. In December last year it was reported that the faulty implants had been tentatively linked to cancer in France. Eight women whose PIP implants had failed had had the disease, including one who suffered a rare form of lymphoma and died. Street protests began in France, the French state health service said it would pay to remove the implants, and similar calls began here. Last week, the health secretary Andrew Lansley said free removal, but not replacement, would be offered for women who had the surgery on the health service (most of them mastectomy patients), and suggested that private clinics had the moral duty to do the same.

Some clinics are refusing to replace the implants free of charge, and Catherine Kydd, who discovered her PIP implants had ruptured in 2009, has set up a Facebook page for those affected; she's outraged the NHS isn't carrying out a full programme of removals and replacements for all the women involved. Her initial breast implant operation was carried out by a private clinic in 2004, after she started feeling self-conscious about her breasts, following the birth of her two children.

In September 2009, Kydd found a lump in her breast. There is a history of breast cancer in her family, and her GP sent her off to have ultrasound. "This showed I didn't have breast cancer," she says, "but my left implant had ruptured, and the silicone had travelled to the lymph nodes in my left armpit." She was one month outside her five-year implant guarantee, and her clinic initially said she would have to pay £6,500 to have the implants removed and replaced. Finally, after much back and forth, they agreed to remove them for free in July 2010.

They were replaced with another brand of implants. "I'm lucky I've had the implants removed, but I have that industrial-grade silicone in my body now, and I don't know whether it's travelled further than my lymph nodes. I've got burning in my arm, in my armpit, every day."

Kydd wishes she had never had implants, and her story raises a familiar question. Why do women risk it? Of all the areas of the body that could be modified, or augmented, why are the breasts the focus of such an enormous proportion of cosmetic surgeries? As the PIP story has unfolded, some have commented that they can understand why mastectomy patients might want the operation, but not women who have it solely for cosmetic reasons. This seems slightly disingenuous. Because if it is, of course, understandable that someone might want a breast that had been removed to be reconstructed, it's surely not such an enormous leap to imagine why someone with very small breasts might want the operation too. Still, the numbers remain astonishing, a testament to discomfort and self-loathing, to a culture that has come to see bodies – especially women's bodies – as endlessly open to modification. The fact that the rise of breast implant surgery has taken place in tandem with the rise of second-wave feminism, only makes this more perplexing.

It's also interesting to consider why the US and UK hold large breasts in such thrall. Because while breast implant surgery is popular in many countries, figures released by the International Society of Aesthetic Plastic Surgeons (ISAPS) show it's proportionately far less popular in China, Japan and India, for instance, where lipoplasty (fat removal), rhinoplasty (nose augmentation) and blepharoplasty (modification of the eyelid) are all much more common surgeries. (The ISAPS figures should be approached with some caution – 20,000 plastic surgeons were asked to participate in the study, and there were 698 replies by the deadline – but they provide a useful general overview.) And even in countries where breast implants are very popular, the overall aesthetic is often different. In Brazil, for instance, there's often a strong focus on the buttocks as well, while some suggest that French women prefer a smaller breast.

Douglas McGeorge, a plastic and reconstructive surgeon, and past president of BAAPS, says there are two groups of women who tend to opt for the procedure. "Those born with small breasts, unhappy with the size, and wanting them to be made bigger, who tend to come in in their late teens and early 20s. Then there are the people who have had babies. Their breasts have got bigger, and now, with pregnancy, they've just emptied, and they're left with a skin envelope, and are wanting something to fill it." All women should be properly counselled before the procedure, he says, but "some of the clinics have counsellors, in inverted commas, who see them, and they're essentially sales people ... The counselling process is very important, because [women] should understand the limitations of surgery, and indeed the potential complications."

These complications include capsular contracture, which involves scar tissue forming around the implant, squeezing it into a sphere, and causing hardness in the breast. Lindsey experienced this, as have thousands of women since. "When you cut the skin there's also always a small risk of wound infection," McGeorge continues, "and infection around an implant is a problem, because if you have bugs there, you actually have to remove it in order to treat the infection, allow everything to settle, let the scar soften up, and the implant can't go back in until a number of months afterwards. It's important to discuss infection, because obviously you can get oozing, a collection of blood, a haematoma. There is also a chance of interfering with the nipple sensation, which is usually only temporary."

Many breast augmentation doctors are male, but it's too simple to suggest it's just an operation imposed on women by men. The writer Teresa Riordan, former patents columnist for the New York Times, and author of the book Inventing Beauty, analysed the beauty industry between the mid-19th and mid-20th centuries, "and it was just phenomenal the different contraptions women had used to augment their breasts. I was astounded, because I thought it would be mostly men who had invented these breast augmentations, but actually it was mostly women." She uncovered a 19th-century book called The Ugly-Girl Papers, "which basically advised just rubbing your breasts very harshly with an abrasive towel to pump them up". There were suction devices, and a wire device used to create a bird cage effect around the breasts.

Dangerous substances had been injected into women's chests, "since probably the 1890s," says Riordan. These included paraffin and animal fat, and after the second world war silicone started being injected directly into the breasts of Japanese women, to try to meet a western ideal. The silicone gel implant was clearly a step up, and in the early 1960s, Cronin and Gerow mused on why women might desire it. "Perhaps this is due in large measure to the tremendous amount of publicity which has been given to movie actresses blessed with generous-sized breasts," they wrote. "Many women with limited development of the breasts are extremely sensitive about it, apparently feeling that they are less womanly, and therefore, less attractive. While most such women are satisfied, or at least put up with 'falsies', probably all of them would be happier if, somehow, they could have a pleasing enlargement from within."

Women who have had breast implants are often perfectly open and analytical about the cultural pressures that led them to it. Michell Anne Kimball, president of the San Diego County Equestrian Foundation, had breast implants four years ago, aged 44, when nearing the end of her horse-training career. She lives in southern California, where the western body ideal is especially prized, "and there's a lot of pressure not to age", she says. "Ageing gracefully is a lost concept for us ... Advertising is detrimental, and I look at lingerie ads, and they're selling sex, and they're selling this to men, they're not selling it to women. They're creating a situation in which women behave in ways that they otherwise wouldn't." She's athletic, she says, and knows she shouldn't "have these feelings about my body", but is very glad she had the operation.

Virginia L Blum, English professor at the University of Kentucky, and author of Flesh Wounds, a study of cosmetic surgery, says breast implants have become normalised in the past few decades. "I was watching an actress on screen the other day, and it was clear she had breast implants, and I thought, well, actually, I see that all the time. It's unnatural-looking, but it has become natural to see it. It's part of our aesthetic landscape. I think it's now considered not extreme, but rather routine maintenance ... saggy breasts are no longer considered an inevitable result of childbirth, but rather experienced as a deficit."

Ninety per cent of all cosmetic surgery operations are performed on women, and Blum thinks this is because "women continue to experience their body as more mutable. I think women are raised around a fashion magazine culture in which we realise we can work on different body parts – we can divide and conquer. Plastic surgery approaches the body in much the same way that women are trained from girlhood to approach their bodies. Male bodies are not quite as available to that model, although I think they are becoming increasingly so".

Blum sees surgery as being related to consumption. "You've consumed this body transformation, and you have a really great feeling, and you want to sustain that feeling. That's the thing with surgery: once you're in it, you're in it. You either have a bad result, and have to re-do the surgery because the result was insufficient, or the result was really great, and you want to reproduce that intoxicated feeling".

Jennifer Hayashi Danns, a former lap dancer who has written about the industry, says there was constant discussion about breast implants. Photograph: Frank Baron for the Guardian

The writer Jennifer Hayashi Danns, author of Stripped, also sees breast implants as an operation keenly related to materialism. Now 28, Danns worked in a lap-dancing club in her early 20s, where there was constant discussion of breast implants – it sounds like a much heightened version of everyday British pop culture, with our ubiquitous breast implant advertisements, bared breasts in newspapers and on magazine covers, women with breast implants filling the casts of reality TV shows, as well as easily available pornography. Danns felt confident about her body when she started at the club, but after eight months she had implants to increase from a C cup to a DD. She regrets the operation now, but at the time there was a feeling of "instant gratification" she says. "It wasn't a question of profound, long-term happiness. It felt like getting a new car, or a new bag."

Danns and I talk about why the implanted aesthetic is so popular. It can't simply be that people fetishise breasts because they're so often covered. In that case, any size or shape would be appreciated. Could it be that, subliminally, it's because men are attracted to women who look like they're nursing, who look supremely fertile? "But if you go down that biological route," says Danns, "we'd also celebrate big, child-bearing hips. And they're a big no-no. It's just a fixation with the breasts. Also, if it was an association with breast milk, then why wouldn't all women be attracted to breast implants too? Women are breastfed as well."

In fact, the aesthetic doesn't seem to be about the functional breast at all. The implanted breast is obviously sexual, but has often lost some, if not all, sexual sensation. It represents fertility, but can interfere with breastfeeding. Kimball sees it as an image of health, which is also often the case for women who have had mastectomies, whose breast implants allow them to look in the mirror without seeing their surgical scars, without being reminded of a horrible disease. But unfortunately the implanted breast isn't exactly synonymous with health. The function of the breast that's enhanced for cosmetic reasons is its sexual display. The implanted breast represents a "perfect, unused breast", says Marilyn Yalom, author of A History of the Breast, "and I say unused, because they're not there for nursing. And that attitude goes back at least to the Renaissance, where you have men not wanting their wives to breastfeed, because the breasts will be used by the babies, they'll change their shape, and so wet nurses come in. There have been times and places, historically, where it was uncommon for women of a certain class to breastfeed."

The popularity of cosmetic breast implants also reflects just how utterly in thrall we are, as a culture, to gender distinctions. The breasts are the biggest physical sign we have of difference, and perhaps, at base, that's why they're so enormously popular. "It's an external symbol of a woman's gender, and we need and want that affirmation," says Biggs. He has been involved in more than 8,000 breast implant operations during the course of his career, and says he "began to realise the magnitude of the importance of the breast to a woman, and to how she feels about herself. So people can make jokes that the breast implants are done to attract men, or maybe to make other women envious. And there may be some minimal elements of truth there. But the real truth is that it helps her confirm to herself her own gender." Biggs and I talk through some of the complications he has seen during his career – of the 11 women who were implanted at the same time as Lindsey, "all were successful, but they all had troubles, and problems" – and I ask whether the experimental nature of what he was doing, in inserting sacks of silicone into women, ever worried him "Oh no," he says. "I'm not a worrier."