Thursday, March 22, 2012

Busted

PIP silicone implant
I can't summon words to express my anger and frustration over the latest silicone breast implant news, but Naomi Wolf can, in her February 15, 2012 Guardian article,  "The Silicone Breast Implant Scandal".

Wolf writes (links provided by her): "Dr Edward Melmed, a plastic surgeon from Dallas, told an FDA panel in 2011 that the implants were an "industrial toxin".

"The symptoms, they are real," he said. "I answer five to seven emails a night from women all over the world, asking, 'What do I do about these symptoms?'" Melmed told the FDA that by 10 years after patients get them, 50% of silicone implants have ruptured; 72% by 15 years; and 94% rupture by 20 years:

"Why is the FDA continuing to allow a device to be placed in young women that is guaranteed to fail [in] 80% [of cases] in 10 years? Would they allow that in hip replacements? Would they allow it in men?"


What is our part in this?

Women who get implants seek larger, symmetrical, firm breasts. We want them because we hope to look ideal, especially concerning a visible, prized, fetishized body part. 


"A" close call

At twenty, an A-cup on a good day, my self-consciousness could not be lifted by any amount of Twiggy comparison. I accompanied my roommate Bonnie, whose med-school boyfriend was a relative of a cosmetic surgeon who would give us a discount. Dr. L. handed translucent Dow Corning domes, squishy and warm, to  each of us to hold. The material, he said, would last for life, top-ups unnecessary. He assured us there would be no problems if we "did our part", massaging our breasts every night at bedtime for ten minutes.

We could pay in two installments, like buying a stereo: 50% in advance and 50% at arrival for surgery. We should book then and there. "One day", he said, "you'll have husbands and you won't want to do it then." 

My blood ran cold as he described the incisions. Besides, I couldn't raise the cash, and I knew my parents would never approve. Bonnie, flush from a summer waitress job and staked to one breast from her aunt (an odd 20th birthday gift if I ever saw one), got lushly pneumatic before the start of our senior year. 

I envied her in the babydoll mini-dresses she bought to display her bounty. Within three years, though, no amount of massaging dispersed the hard lumps in both breasts, and she had them removed (by another doctor). Bonnie also removed the boyfriend who had enthusiastically championed them.

By the mid-1970s women knew that implants, especially silicone, were a significant risk. In the US in 2008, new silicone implant technology was approved by the FDA ending a nearly 15-year ban "thanks to industry lobbying", as Wolf's article says.

Forty years later

Why are we still doing this?




48 comments:

déjà pseu said...

Duchesse, I don't know. And while our culture may festishize large breasts, certainly not all men do. Having been large breasted since my teens, I would have traded for those A-cups any day. I've pondered reduction surgery, but, well...surgery. (Not to mention the pain and $$.) I also worry about some of the substances that women are injecting into their faces...what will we learn 5, 10 years from now?

Chicatanyage said...

Who knows. Peer pressure. Celebrity culture. In summer in St. Tropez on certain areas of the beach it is difficult to find a woman whose breasts do not stay vertical when she lies on the sand . What does that say about the society we have created?

materfamilias said...

Horrifying to me that this mutilation can keep going on, despite the regular and predictable problems. So relieved that my daughters bypassed any temptation -- I can't imagine how frustrating it would be to watch a daughter's body transgressed by such a cosmetic invasion -- and they're all our daughters, no?!

Jane W. said...

"did our part"

Ugh. Love how that places all of the responsibilty on you and your friend.

M said...

At least part of the problem is the fast track approval process at the FDA called 510(k). It's is much less rigorous than the full review and needs to be revamped or removed completely. It's not just breast implants either. Many devices are approved this way including knee and hip replacements, CT scanners & drug pumps to name a few.

As for why women continue to get cosmetic implants I think that story is as old as time and I doubt it will ever change.

Anonymous said...

All kinds of cosmetic surgery (except for the wonderful restorative work done on trauma victims and children born with severe defects) are beyond my understanding. On television the other night a program with several actresses in their 40s and 50s horrified me: every single one of the women had been disfigured--no other way to describe it--by implants and facelifts, lip injections and botox. They all looked swollen, somehow, as if they'd been beaten up--as they had been, by their unprincipled doctors, their industry's absurd demands, and their own vain fears of growing old. As for the FDA and silicone, I don't know. Normally it is known as an extremely tough watchdog, but I believe that it has always been tougher on drugs than on devices. I'm not sure why this is so; maybe because the FDA is physician-oriented, and see devices as engineering problems? (Until they spill their contents into a woman's bloodstream.)

In any case, the real answer is obviously to eliminate the demand for these ridiculous, and as Pseu says, fetishistic, items. How can we convince girls that they are good enough as they are? Years of feminism count for nothing if a young woman feels she must insert plastic bags full of chemicals into her breasts to be loved.

C.

M said...

Actually years of feminism has probably contributed to the problem because so many relationships now are just about looking hot & having sex. So many woman today ask very little if the men they date. Men have learned that they don't need to respect women. They can very easily get what they want without it.

LPC said...

I hate to judge, and to each her own, but good lord, as a AA young woman I never even considered implants. That thought of something in my body that doesn't belong there makes me crazy.

hostess of the humble bungalow said...

It's ridiculous that women still undergo this procedure with the known risks.
I do not understand it.
Perhaps Hugh Hefner could share some light on the topic.

It's different if one has a mastectomy and undergoes reconstructive surgery but they use the flesh from the stomach area not silicone implants...

My mother opted not to have the reconstruction...
but that's her choice...
I suppose in the end it's all a matter of personal choice.

Monkey said...

I'm as flat-chested as they come but I can't imagine putting these ghastly things in. And while some men are into breasts, I've managed to find several who were not!

Mardel said...

As an A cup I may have been self-conscious about my small-breasted status, but I never considered implants. Even then, the thought of any surgery that wasn't absolutely necessary horrified me. Still does. And yet there are too many who don't care, or don't understand the risks, I don't know. But then I think too many people see surgery of many kinds as a quick fix without considering the risk/benefit ratio. Perhaps statistics should be made a part of the essential educational curriculum.

Chanterelle said...

During the recent outrage in France over a presumed cancer connection they actually arrested the CEO of the company that manufactured the implants. The last I heard, it was decided that the national health service would pay for removal of the implants but not for reconstruction. Huh???

ming said...

I, too, don't understand. Just as I no longer understand why people smoke. I was very, very large breasted after my children were born. Opted for breast reducion. Best decision I ever made.

Pseu - all surgery is not great - but this was easy (as they come) 4 days away from work, 6 weeks with no exercising and paid for by my insurance company.

Susan said...

I always hesitate to comment on this topic as I was "blessed" with a breast size that most would consider just right. So, I don't know what it is like to feel self conscious about being very small. From my perspective, I can't imagine wanting to have implants---but don't feel like I can judge the decisions of others. And no, I won't be having a facelift or botox either

Has anyone ever noticed that most photographic models have small breasts? They truly do look better in clothing when phtoographed.

tinyjunco said...

all i can say is thank you for posting this article. steph

SewingLibrarian said...

M Mar, I agree with you.

Duchesse said...

pseu: Two of my friends had reductions b/c of severe pain and postural problems. Not major surgery and no foreign object in you. I'd put it in an entirely different category, like your hip replacement.

chicatanyage: Very weird to see a woman with a 60 yr old face and 25 yr old breasts.

materfamilias: Well put, an invasion. And still the #1 cosmetic surgical procedure.

Jane W/ I found him patronizing even then and the part about no husband yet so get it done creeped me out.

M: I might take the time to read further how these implants ended up in women; your succinct summary just makes me more upset (in a good way), and thanks.

C: I had but a few years of feminist consciousness in me, but apparently just enough to be creeped out by the doctor. And I also agree. Some young women say they "are in control" b/c they make the decision, but I find that a facile argument.

M: I can't quite connect those dots of your comment with the foundational feminism I encountered in the late '60s/early. We would not have advocated "looking hot" as a primary goal. Is that goal that of more recent 4th(?)-wave? Men back then taunted women who did not wear makeup and shave their legs with "You must be one of those women's libbers."

Jill Ann said...

I have four sisters-in-law; three of them have breast implants. Two of them were small-busted, but not flat, and the other one (brother-in-law's wife) had hers "refreshed" after 3 kids. The first two, IMO, look quite unnatural, but they seem happy with them. I did judge, I admit, when they got the surgery. They told me I wouldn't understand because I "always had boobs". True, but I'd rather have the B cups I had in my teens and twenties, than the Ds I have now!

The other thing that concerned me about this, other than the inherent risks of surgery, is that we all have daughters. What kind of example are we setting for them (I asked). So far, none of their daughters have had implants, although I suspect it's just a matter of time as they are only in their teens and very early 20s. I am the only one with any feminist views, and as it happens, my two daughters are the only busty ones of the group! So no surgery for the three of us! Quite honestly, I would really like an eye job, but doubt I will ever do it. Surgery!

M said...

Hi Duchesse, Yes, unfortunately feminism has devolved into something much less meaningful than equal opportunity.

For years too many feminists refused to acknowledge that men & women are by nature different & that has resulted in a sad need by some woman to prove that there is no difference in how women and men feel about sex.

Look at at the hook- up culture on college campuses. If you're not having sex by the third date you're considered some kind of prude. It's a man's paradise. So to stay in the game you've got to stay competitive.

It's depressing really & the good news is I think many young woman are starting to question this whole paradigm.

Terri said...

I heartily agree! I have a colleague who has had her breasts "done." She has a great sense of humor about the way the rest of her body has "fallen," but not those pert breasts. On the other hand, I have heard of young women who received breast implants as a high school graduation gift. I'm not sure we can fault the doctors, as much as women who want them. And I don't know what the corrective is for that.

Digs said...

Great post. I had no idea the failure rate was so high (are these current stats?). The ironic thing, though? Guys like ALL women. So tell me the men I have polled. "we like women, period", is what I hear. That's a message I'm very happy to transmit to my A-sized daughter.

Duchesse said...

LPC: I am abut 10 years older than you, and when we made that visit they were quite a new phenomenon.

hostess: Breast reconstruction uses various methods, some women do get implants. That of course is an entirely different matter.

Monkey: From what I hear many partners are turned off by fake breasts.

Jill Ann: Oh would I get myself in trouble with them! And I hope those daughters "rebel" and have noting to do with implants.

M: "Actually years of feminism has probably contributed to the problem" was your premise, and I'm distressed to see what I long worked for has (in your opinion) led to the hookup culture. Feminism as I came to it was, and still is, about self-respect and autonomy.

Just as certain politicians promote the current erosion of women's reproductive rights (in the US) as the "return to family values" or the even scarier vague reason that it's "just not natural", so have some women justified some behaviour under the banner of "freedom". One can stick almost any behaviour under some self-justifying banner, if one wants to.

As far as denying differences between men and women, the groups I belonged to did not, although they did view women as victims of a patriarchy. Many came to see that victim stance as limiting.

Terri: I wish her, and any woman with them a safe experience. I've heard of a few doctors who refuse to do them unless it's reconstructive after disease or an accident.

Digs: Wolf has links in her article to the Melmed research and yes, stats are current. The males in my household (a small sample, admittedly) endorse your poll results :)

pinkazalea said...

There are so many reasons as you can imagine. I've known women who had very modest implants to correct very small (really no) breasts. I've known women who've had implants following a mastectomy which seems to be part of an overall healing process. Then there are all the others with obvious large and artificial-looking implants, influenced by the men in their lives or just because they like the look. When it becomes more fashionable to have a natural appearance or the look of a small bustline becomes desirable, it will change. And yes, I think the complication rate is definitely a risk.

M said...

Hi Duchesse-"Feminism as I came to it was, and still is, about self-respect and autonomy". In the beginning that was true. Today, feminism is mostly about claiming victimhood and demanding special protections from the government.

As for the hook-up culture, for years feminists insisted that woman should be able to have as much "no strings attached" sex as men and this is the result. But, it is a fallacy to believe that do so has no consequences, and yet this idea has been propagated by feminists for years and I think woman are suffering for it emotionally.

So here we are, stuffing implants into our bodies & injecting toxins into our faces in some attempt to make ourselves more appealing to the opposite sex and all the men have to do is pick and choose. That doesn't represent a cultural leap forward in my mind.

Anonymous said...

Dear Duchesse,

Some of the mind-boggling discussions taking place in our presidential primary campaigns might be a rich topic for a future post. I think that most women my age are astonished to find birth control--BIRTH CONTROL!--made a political issue in 2012, and the limiting of access to it described as the protection of religious freedom. Sorry to go off-topic here, but M.'s comments remind me that the puritanical strain is never too far beneath the surface of American life, and that we remain a society very confused and conflicted about sex.

Back to the subject of breasts: I once heard a plastic surgeon say that his most satisfied patients were unquestionably those who had had breast reduction surgery, rather than any perfection-seeking "enhancement." Makes sense to me.

C.

Jill Ann said...

Maybe we are getting a bit off topic here, but it's impossible for me to ignore M's comment that "feminism is mostly about claiming victimhood and demanding special protections from the government". Are you kidding me? I'd venture that of us would say feminism is about leveling the playing field, providing equal opportunities for women, making it unacceptable for women to be refused jobs, promotions, bank loans, etc, just because they are women.

I would also bet that the breast implanted, face lifted, heavily botoxed, promiscuous women you are concerned about probably do not self-identify as feminists, for the most part. That stereotype of woman clearly doesn't value herself as a person independent of male approval; ergo, not a feminist.

Rubiatonta said...

Someone I love had implants after a double-mastectomy, and that I certainly understand, but I can't get my head around the idea of elective surgery of any sort!

That's not to say that I wouldn't mind getting rid of the "poof" on my tummy, but only if it wouldn't hurt at all. I'm too much of a owie-baby.

Spain is a paradise of plastic surgery; it's #10 in the top 25. Our neighbors, Portugal, are at #25. (The top three, in order, are the U.S., China, and Brazil.)

Jill Ann said...

Meant to say, "I'd venture that MOST of us". Proofreading is your friend!

Btw I probably would get implants if I'd had a mastectomy. That's a whole different issue than wanting to look like a celebrity, I believe.

M said...

It's not mystery how contraception made its way way into the campaign. The Obama administration framed the argument so that it would look like a women's rights issue so you who refuse to do ant critical thinking would get in line & support this. The true issue is that the US government has no authority to tell a private enterprise that they must give something away for free. We are a free enterprise system & this HHS diktat is unconstitutional.

As for your attempt to portray me as a puritan nothing could be further from the truth. Woman should having ad my h sex with whomever they want. My point us that young woman often don't consider the emotional consequences of this & I find it very sad.

Duchesse said...

M: When you write things like "...so you who refuse to do any critical thinking would get in line", it's a cheap shot and close to the kind of post I remove (as I've said under "Leave your comment"). When one feels intensely about an issue, insults might spring to mind, but I don't want to publish them.

Duchesse said...

pinkazelia/Rubi: Breast reconstruction (implants are used only sometimes) is another matter; the vast majority of implants are vanity surgery. If I ever undergo breast reconstruction I would not want anything with toxic potential in my body.

Jill Ann: It's been confusing, educational, and sometimes puzzling to see how women claim, reject or ignore the term "feminist" over the last 40-odd years I have paid attention. As with any movement, there is a range of belief, so I'm always listening to what people *do* with that identity.

Duchesse said...

C.: If it had not been for accessible birth control, so many lives would have proceeded differently, certainly mine. I'd guess many of the women reading this blog would have the same experience.

M said...

Ok fair enough but why not respond to the real issue at hand- the fact that this administration via this mandate is acting as if they have the authority to demand that a private company give something out for free. Again, it's plainly unconstitutional & yet this doesn't seem to bother you.

Duchesse said...

M.: It is not the topic of this post.

lagatta à montréal said...

M, la Duchesse lives in Montréal (and of course is perfectly capable of speaking for herself).

Yes, this sounds very similar to the recent French implants scandal.

Anonymous C.March 22, 2012 10:51, your reference is to plastic, not cosmetic surgery. It is a shame that surgeons who could be making the victims of birth defects, accidents, diseases and even maiming liveable are making far higher salaries installing these things and injecting botulism toxin (yecch).

I've been very busty since puberty, and would have preferred more modest breasts as it is easier to move about and do exercise, but like pseu, I'm terrified of surgery - and would also fear a loss of sensitivity that would adversely affect libido.

In terms of funding, breast reductions are covered under National Health Insurance, if there is a serious functional reason for them, as are breast reconstructions for women who have had to undergo mastectomy. A friend had one done, but with tummy fat, and it is of course no larger than her original size.

M said...

Didn't mean to hijack your post but I feel very strongly about this and get incredibly frustrated when I see other women posting such uninformed commentaries. It's as if you all been programmed to keep repeating some kind of feminist mantra. While you are all talking contraception, our US government is behaving like some third world dictator. I like your blog and appreciate the opportunity to express my opposing point of view. My apologies if I have taken up too much space with my many comments.

Anonymous said...

Amen Duchesse! I think that a high proportion of the time, counselling would be of more value then surgery (plus a style consultant to show women how to rock what they've got and minimise stuff they're less fond of).

I'm on a weightloss website and it kind of shocks me how many women there have or want to have breast implants. I wouldn't do it (and my husband wouldn't like it at all). I *might* if I felt very strongly, have a breast lift, but really I think I'd be fine with a good bra.

Cheers,
Eleanorjane

Duchesse said...

eleanorjane: Grateful that you are not going to do it. Significant weight loss (especially from mid-life on) can leave loose skin, so I understand how women who have worked so hard to reduce are dismayed. A lift is not without risk either, but at least a woman is not living with an implant.

diverchic said...

Whew! What a discussion;so many new topics to consider!
Back to the question "Why are we still doing this?" Regarding enhancements, I believe the answer is called body dysmorphic disorder in which the person has a very distorted view of their own body. Regarding reductions, having watched my lovely mother struggle with breasts that pulled her spine out of line, I know this is a health issue not a beauty one.

Duchesse said...

diverchic: In the case of the women I know who had implants, they did not display that level of distorted body image. Maybe watching too many episodes of Extreme Body Makeover will do it!

Anne said...

It's one thing to question the safety of silicone breast implants and another to question their popularity.
I had silicone breast implants as my reconstructive surgery choice after a double mastectomy, and to many of you, that gives me a free pass. Not sure it should, but I'll take it. Women with mastectomies are just pushed into an extreme calculus of weighing the value of breasts as an important part of our body image and identity. It was a difficult decision to make at age 52. In fact, it was much harder to decide what if any type of reconstruction to have than the decision to have a double mastectomy. They aren't perfect and I'm still a little shy about anyone seeing me naked, but I know I wasn't ready to go breast-free. The only thing that would have made it easier would have been living in a breast-neutral society. Don't think we are close to that. So I'm glad I had a couple of imperfect choices and for me it came down to saline implants or silicone. By the way, autologous breast resconstruction using one's own body tissue is MAJOR surgery. I rejected (no pun intended) that immediately because I felt the cost, the medical risk, recovery, and invasiveness put this in a whole different category of "Not Worth It."
I believe that the experience of silicone implants varies by manufacturer. My breast reconstruction surgeon (a lovely woman) counseled me carefully and steered me towards silicone rather than saline whose rupture rates were not as good. No promises were made to me that this is a forever and ever implanted device and I might have to make another hard decision in the future. At some point I think I'll be ready to go breast-free, but of course wish I didn't have to think about this at all. All I know is that I had to spend a lot of time over 15 years thinking about the role of breasts in my life, whether I should keep them, whether I should allow substitutes, and all of those decisions were in part bound up with the image and idea of myself as a woman. It's just hard, and I feel a little more open-minded about others' decision to have cosmetic breast surgery. Mine are cosmetic too.

lagatta à montréal said...

Anne, my friend who had such autologous reconstructive surgery did indeed find - in physical terms, leaving aside both terror of imminent death and horror of mutilation - the surgery on her belly much harder to recover from than that higher up.

I do NOT see reconstructive surgery after any form of mutilation, (even medically necessary), trauma or birth defect as "cosmetic". Neither do the surgeons I know. It is a question of feelings of bodily integrity.

There was no personal cost to my friend, except of course that all our taxes pay into the national/provincial health system. And she is fine.

I hope you will be, too!

Duchesse said...

Anne: I am grateful for your comment.
According to this site (http://www.breastimplantinfo.org/what_know/bihlthcomp.html), 80% of implants are for cosmetic reasons, not reconstructive. those are the cases I question, and I hope your new breasts are deeply satisfying and restorative for you.

While I would never presume to know how your experience has been, I think I'd get them too.

Adrienne said...

I have plentiful boobs. I saw a colleague go through two mastectomy surgeries after two bouts with breast cancer.Not fun to say the least!
I fight with my boobs they are in the way and make me wear larger than I would like tops but... they are God given and I decided not to make an art project out of them. At this point in my life if I develop breast cancer off they will come with no replacements.. I want to experience life with or without boobs.
Women who feel differently than me are entitled to make up their own minds and I wish that there were always safe options for them. I want my fellow females to be happy with themselves whether God given or surgeon enhanced.

Duchesse said...

Adrienne: I was with you till the last sentence. In the case of cosmetic (vanity) cases, which are 80% of the women getting implants, I wish they would not insert a device that has had a lousy track record for serious health risks and malfunction. If that is what it takes for women to be "happy with themselves", I think we have a big problem with our values.

lilly said...

Very interesting and timely discussion, since I have been seriously considering implants and meeting some surgeons for consultations.

I nursed my three children for three years each, and loved every minute of it. However, after nearly a decade's worth of nursing, my formerly "just right" breasts have deflated. The issue isnt that they are small, which wouldn't bother me, but that the fat has disappeared, leaving an empty pouch. Although my husband has never complained, and never would, I don't like how they look. My goal would not to have larger breasts, but to restore the way they looked before. If implants are safe, I would not hesitate to get this taken care of...to me it's not fundamentally different then wearing beautiful clothing or jewelry, or anything else that we do to look beautiful to the one we love.

So I've been looking into the safety issues again, especially after reading your post. As far as I can tell, the problems with silicone implants date from the time in which the silicone was liquid, and therefore could seep out into the rest of the body. The FDA-approved implants used today are a solid gel that, in the event of rupture, remain solid and don't (can't) travel to other parts of the body. I'd appreciate it if you have information about health risks for implants, you could please post.

lilly said...

To be specific, when I say "information," I mean medical articles in reasonably-high impact peer-reviewed journals in the field. I've done pubmed searches, and expected to find more specific information about the new solid gel implants (particularly in light of autoimmune diseases, since I have Graves) but thus far the medical consensus seems to be that they are safe (which makes sense, given their FDA status).

Duchesse said...

lilly: It is essential for you to do your own research and make your own decision. You will find that rupture is only one of the issues.
re "if implants are safe": "safety" is a term loaded with bias. Your assessment of safety will depend on how much risk, from both the surgery and implant, you are willing to accept.