Every thing's bigger in Texas. Hair, oil business and, yes, even boobs. And they don't come from drinking the water.

Houston - the nation's fourth-largest city - is the birthplace of the silicone gel-filled breast implant. Doctors Frank Gerow and Thomas Cronin, two Houston plastic surgeons, developed the silicone breast implant in the 1960s after watching an IV transfusion bag. Previously, silicone had been injected directly into the breast by Japanese hookers with some rather hideous results so encasing the gel inside a baggie seemed like a good idea.

"IVs used to be in glass vials," said Dr. Ernest D. Cronin, nephew of Thomas Cronin. "They had just come out with the plastic bags and my uncle and Dr. Gerow were feeling the bags and thought 'this feels like a breast.' You know how men are."

From there the team went to Dow Corning to develop the implants. In 1962 Timmie Jean Lindsey became the first patient to receive the implants at Houston's Hermann Hospital (now Memorial Hermann Hospital) and an industry was born.

The docs had no dearth of patients eager to try the implants, Houston, which has the largest medical center in the world, also just happens to be home to a rather large men's club industry anchored by Rick's Cabaret, the first publicly traded strip club in the world. Houston strippers, most notably Anna Nicole Smith, lined up for the bigger boobs.

But Houston is also known for its plaintiff attorneys, so it's no surprise that the first breast implant lawsuit was filed and won by local lawyer Richard Mithoff in 1977. Dow Corning paid the plaintiff $170,00. The case largely went under the radar, but it was another Houston lawyer, John O'Quinn, who turned his $25 million win against Bristol-Myers Squibb into a cottage industry eventually handling thousands of suits against the makers of the silicone gel-filled implants. He made so much money that an arbitration panel recently told him to give back more than $41 million to a class of 3,450 former breast implant clients who alleged O'Quinn's firm overcharged them for expenses. But we digress. Sympathetic juries were handling out money to women alleging cancer and disease links to their implants like popcorn balls at Halloween. Eventually the industry set aside a record $4.25 billion for the class-action suits.

In 1992 the FDA banned the use of silicone implants except in certain reconstructive control groups. Other countries continued to use them and in Europe substantial research showed no correlation between the implants and the diseases the American lawsuits claimed were caused by them. Yet the litigation and the ban stayed.

"That will go down as a very shameful period in time," Dr. Michael V. Kelley II said. Kelley was an operating room tech when he first met Dr. Gerow, whom he remembers as a very colorful character. But his memories of the implant litigation aren't so fond. "I don't believe any of the hocus pocus that went on with the attorneys. There was a problem with silicone bleed in some of the early models, but I don't think that was harmful. They put silicone in lipstick and that's not a problem." Actually, even the saline filled implants use a silicone bag. But for whatever reasons, the lawsuits kept coming.

The history of the invention of the silicone implants, the breast boom in Texas and the spiraling litigation, was fodder for the 1997 HBO film "Breast Men." The tag line pretty much says it all: "Two young doctors with a dream of making it big. Really big." Set in Houston and loosely, very, very loosely, based on the real story, the film, which starred David Schwimmer and Chris Cooper, did not use doctors Gerow's and Cronin's real names. For obvious reasons like, oh, porno star girlfriends and drug abuse. The flick was not a hit with Houston surgeons.

"None of those people were really like they were in that movie," Dr. Kelley said. "Most plastic surgeons have a different personality, but that was just made up." Cronin concurs.

"My uncle was a very kind man, the antithesis of that movie," he said.

Not that the movie - largely panned by flick critics - had anything to do with it, but it did take 14 years for the medical community and government agencies to finally come to the conclusion that silicone implants were not harmful. Now, more than a year after the FDA lifted the ban on silicone gel-filled implants, they are more popular than ever. Both Mentor Corporation and Allergan (formerly Inamed) produce the implants for use in America.

According to the American Society for Aesthetic Plastic Surgery, 11.5 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2006. And guess which procedure is most requested by women?

"The FDA approval of silicone breast implants in late 2006 seems to have made an impact, as silicone implants are up 18 percent from 2005. For the first time breast augmentation is the top surgical procedure for women, although lipoplasty continues to be the top overall surgical procedure as it has been since the Aesthetic Society started collecting nationwide procedural statistics in 1997," said Aesthetic Society president James Stuzin, MD.

So what's on the horizon? More breast augmentation, particularly for women 40 and up. The so-called "mommy make-over" is attracting baby boomers and empty nesters who want their before-children bodies back. What with the glut of reality make-over TV shows, celebrity boobs and media frenzy, 2008 should be another banner year for boob jobs. And the choices for breast enhancement are growing as well. The so-called "gummy bear" implant, a silicone gel that you can cut in half without leakage, has been used n some countries since the late 1990s and is being developed for approval in America now.

"Breast augmentation is just real popular," Dr. Kelley said. "Sometimes I wonder if Dr. Gerow ever thought about what he was creating? Breast implants are done all over the world today."

And it all started in Texas.