PERSPECTIVE ON WOMEN’S HEALTH : Choosing Any Surgery Is a Personal Right : Politics, not science, would have millions live without breasts at all; the attack on implants is arrogant and sexist.
I am used to hearing wisecracks from people who think that a plastic and reconstruction surgeon from Southern California must cater solely to human vanity. But I know that vanity can also be the healthy motivation behind seeking reconstruction surgery after terrible accidents, to overcome congenital deformities or to cope with the impact of ravaging diseases like breast cancer.
Most women with breast cancer undergo mastectomies, and the number seeking breast reconstruction has reached 35,000 a year. Breast implants have been used safely in this country for 30 years, and a national survey found that 96% of women with breast implants would choose them again.
Yet in the past year there have been about 2,000 articles in the press critical of breast implants, linking them with everything from cancer to connective-tissue disease.
I have never seen in my practice, nor read in the medical literature, any scientific proof of these charges. In fact, rates of breast cancer or disease in women with implants are as low as those in women without implants, even lower in a study of 3,200 women with implants conducted by USC.
The Food and Drug Administration is reviewing implant manufacturers’ safety data in order to make a determination on the extent of risk. A small but vocal group is pressuring the FDA to ban implants altogether. The FDA may decide that breast implants’ benefits outweigh potential risks--but only for women who have lost breasts to cancer. The 75% of women who seek implants to augment healthy breasts would have no option, at least not in the United States.
The forces calling for a ban seem to me to be engaged in a misguided attempt to protect women from themselves. How arrogant! How sexist! And why target breast implants? No one dreamed of taking tampons off the market when that product was linked to toxic shock syndrome. Every day, millions of women evaluate that risk for themselves and decide that it is minimal when compared to the benefit.
Already women are suffering the ill effects of this controversy. Some insurance companies are excluding coverage for breast-related diseases and disorders if the insured has a breast implant. And this before the FDA has even collected the data and ruled on implants’ safety! If the FDA should ban implants, I foresee the possibility of at least 2 million women without health coverage for breast-related diseases.
Many of the women speaking against breast implants say that they have implant-connected problems. There is no evidence in the literature of major problems with implants, and minor complications are relatively few and far between. I do not denigrate the suffering that the implant opponents describe; but I do feel strongly that they are pawns in some larger scheme.
The fact is, there is no reason to ban implants or restrict their use. Not even for cosmetic purposes. If a woman chooses to augment her breasts, whose right is it to judge whether her motive is acceptable? Whose right is it to tell her what her appearance should be? Do we tell a man with prominent ears that he should not have them pinned back and insult him for seeking out that procedure because it will improve his self-confidence?
I have had more than 1,000 patients who opted for breast implant surgery, and I can tell you that every one of them had a very good reason. Fortunately, no one was lobbying the federal government to tell them what they could do with their own bodies. Now, I’m afraid, politics, and not science, may sentence millions of women to live without breasts at all.
